Liverpool HIV Interactions

No Interaction Expected

Abacavir (ABC)

Acamprosate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acamprosate is eliminated unchanged in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Acarbose

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. After ingestion of acarbose, the majority of active unchanged drug remains in the lumen of the gastrointestinal tract to exert its pharmacological activity and is metabolised by intestinal enzymes and by the microbial flora.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Acenocoumarol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as acenocoumarol is mainly metabolized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Acetazolamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acetazolamide is primarily excreted unchanged via the kidneys, there is therefore little potential for interaction with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aciclovir (Acyclovir)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as aciclovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Acitretin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as acitretin undergoes isomerisation and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aclidinium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aclidinium bromide is rapidly and extensively hydrolyzed (non-enzymatic and enzymatic transformation by esterases and butylrylcholineesterases) to its pharmacologically inactive metabolites with only a minor role for CYP metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Adalimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Adalimumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Adefovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as adefovir is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Adrenaline (Epinephrine)

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Adrenaline is rapidly inactivated, mostly in the liver by catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO). There is therefore little potential for interaction with abacavir via modulation of, or competition for metabolic or elimination pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

African Potato

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic data there is little potential for pharmacokinetic interactions.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Agomelatine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely as agomelatine is metabolised predominantly by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Albendazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Albendazole is thought to be predominantly metabolised by CYP450 enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Albuvirtide (ABT)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, as well as limited drug-drug interaction data, a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. An interaction is unlikely as albuvirtide is a peptide which is eliminated by catabolism to its constituent amino acids.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alcohol

Quality of Evidence: Moderate

Summary:

Abacavir has no effect on the pharmacokinetics of alcohol. Alcohol decreases the elimination of abacavir causing an increase in overall exposure. These findings are not considered clinically significant.

Description:

The metabolism of abacavir is altered by concomitant ethanol resulting in an increase in AUC of abacavir of about 41%. These findings are not considered clinically significant. Abacavir has no effect on the metabolism of ethanol.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Abacavir has no effect on the pharmacokinetic properties of ethanol. Ethanol decreases the elimination of abacavir causing an increase in overall exposure. Due to their common metabolic pathways via alcohol dehydrogenase, the pharmacokinetic interaction between abacavir and ethanol was studied in 24 HIV-infected male patients. Each patient received the following treatments on separate occasions: a single 600-mg dose of abacavir, 0.7 g/kg ethanol (equivalent to 5 alcoholic drinks), and abacavir 600 mg plus 0.7 g/kg ethanol. Coadministration of ethanol and abacavir resulted in a 41% increase in abacavir AUC and a 26% increase in abacavir half life. Abacavir had no effect on the pharmacokinetic properties of ethanol, so no clinically significant interaction is expected in men. This interaction has not been studied in females.
Ziagen Prescribing Information, ViiV Healthcare, June 2019.

The interaction between abacavir (600 mg single dose) and ethanol (0.7g/kg single dose) was evaluated in 24 HIV-infected males. Ethanol pharmacokinetic parameters were unchanged with abacavir coadministration. There was no evidence that coadministration of abacavir interfered with ethanol metabolism and there were no disulfiram-type reactions in any subject receiving abacavir and ethanol. Abacavir AUC increased by 41% and Cmax increased by 15% and half life by 26%. While these changes were statistically significant, they were not considered clinically significant. The increased plasma abacavir concentrations observed in this study were well within the range seen in previous studies where no additional safety concerns were demonstrated.
Pharmacokinetic interaction of abacavir (1592U89) and ethanol in human immunodeficiency virus-infected adults. McDowell JA, et al. Antimicrobial Agents Chemother, 2000, 44:1686-1690.

No Interaction Expected

Abacavir (ABC)

Alcuronium

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Alcuronium is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alendronic Acid (Alendronate)

Quality of Evidence: Very Low

Summary:

If taken at the same time, it is likely that food and beverages (including mineral water), calcium supplements, antacids, and some oral medicinal products will interfere with absorption of alendronate. Therefore, patients must wait at least 30 minutes after taking alendronate before taking any other oral medicinal product.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alfentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as alfentanil undergoes extensive CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alfuzosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as alfuzosin is metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aliskiren

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aliskiren is minimally metabolized and is mainly excreted unchanged in faeces. P-glycoprotein is a major determinant of aliskiren bioavailability.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Allopurinol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as allopurinol is converted to oxipurinol by xanthine oxidase and aldehyde oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Almotriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Almotriptan is partly eliminated unchanged in the urine and partly metabolized (mainly via monoamine oxidase-A and to a lesser extent by CYP3A4, CYP2D6 and flavin monooxygenase).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aloe vera

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Aloe vera is only a weak inhibitor of CYPs in vitro and therefore is unlikely to cause clinically significant interactions. It does not inhibit P-gp and there is no evidence to suggest it impacts UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alosetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. In vitro data indicate that alosetron is metabolized by CYPs 2C9, 3A4 and 1A2, with in vivo data suggesting that CYP1A2 plays a more prominent role.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alprazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as alprazolam is metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amantadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amantadine is mainly eliminated renally by glomerular filtration and active secretion. A bicarbonate dependent organic cation transporter has been identified as the major uptake transporter of amantadine in the renal proximal tubule.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ambrisentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ambrisentan is mainly glucuronidated by UGT1A9, UGT2B7, UGT1A3 and is metabolized to a lesser extent by CYP3A4. Ambrisentan is also a substrate of P-gp and OATP1B1. Abacavir does not interfere with ambrisentan metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amikacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amikacin is eliminated renally by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amiloride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amiloride is eliminated unchanged by the kidney.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aminophylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aminophylline is a complex of theophylline and ethylenediamine and is given for its theophylline activity. Theophylline is mainly metabolized by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amiodarone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amiodarone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amisulpride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amisulpride is weakly metabolized and is primarily eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amitriptyline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amitriptyline is metabolized predominantly by CYP2D6 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amlodipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amlodipine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amodiaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amodiaquine is mainly metabolized by CYP2C8 to N-desethylamodiaquine, an active metabolite but less potent than the parent compound.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amoxicillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amoxicillin is mainly eliminated unchanged in the kidney and in vitro data indicate that it is a substrate of OAT3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amphetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amphetamine is metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amphotericin B

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as amphotericin is not appreciably metabolized and is eliminated to a large extent in the bile.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ampicillin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Ampicillin is predominantly eliminated unchanged via renal pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Anastrozole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anastrozole is mainly oxidized to hydroxyanastrozole by CYP3A4 (major) and glucuronidated by UGT1A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Anidulafungin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anidulafungin is not metabolised hepatically but undergoes chemical degradation at physiological temperature.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Antacids

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as antacids are unlikely to alter abacavir absorption.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Anti-thymocyte globulin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thymoglobulins are cleared by the reticuloendothelial system.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Apixaban

Quality of Evidence: Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apixaban is metabolized by CYP3A4 and to a lesser extent by CYP1A2, CYP2C8, CYP2C9 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Apomorphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as apomorphine is metabolized by several pathways including glucuronidation, sulfation and to a lesser extent N-demethylation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aprepitant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aprepitant is mainly metabolized by CYP3A4 and to a lesser extent by CYPs 1A2 and 2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Argatroban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Argatroban undergoes metabolism in the liver via hydroxylation and aromatization. In vitro studies indicate that CYP3A4 plays a role in argatroban metabolism, however, human drug-drug interactions studies suggest that metabolism via CYP3A4 is not a major elimination pathway in vivo.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aripiprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as aripiprazole is metabolized by CYP3A4 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Artemisinin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Artemisinins undergo rapid metabolism via several CYP450 (CYPs 3A4, 2A6, 2B6) and the active metabolite (dihydroartemisinin, which has greater potency than the parent drug) is further metabolized via UGTs 1A9 and 2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ascorbic Acid (Vitamin C) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with vitamin C when given alone or in multivitamins. Ascorbic acid is oxidised to dehydroascorbic acid where some is metabolised to oxalic acid and the inactive ascorbate-2-sulphate. Large doses are rapidly excreted in the urine when in excess of the requirements of the body. There is therefore little potential for interaction with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Asenapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Asenapine is metabolized by glucuronidation (UGT1A4) and oxidative metabolism (mainly CYP1A2, with minor contributions from CYP3A4 and CYP2D6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Asparaginase

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolic profiles of both drugs, there is little potential for pharmacokinetic interaction. Limited data suggest that asparaginase is likely to be eliminated by the reticuloendothelial system.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aspirin (Analgesic)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aspirin is rapidly deacetylated to salicylic acid and then further metabolized mainly by glucuronidation (by several UGT, major UGT1A6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Aspirin (Anti-platelet)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Aspirin is rapidly deacetylated to salicylic acid and then further metabolized mainly by glucuronidation (by several UGT, major UGT1A6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Astemizole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as astemizole is metabolized by CYPs 2D6, 2J2 and 3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atazanavir alone (ATV)

Quality of Evidence: Very Low

Summary:

Coadministration with atazanavir alone has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Coadministration of abacavir (600 mg once daily) and atazanavir/ritonavir (300/100 mg once daily) had no effect on atazanavir or ritonavir pharmacokinetics, but decreased abacavir AUC (17%) and Cmax (20%). These changes are unlikely to be clinically significant.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

The coadministration of abacavir and Reyataz is not expected to significantly alter the exposure of abacavir.

Reyataz Summary of Product Characteristics, Bristol-Myers Squibb Pharmaceuticals Ltd, October 2018.

Coadministration of abacavir (600 mg, once daily) with atazanavir/ritonavir (300/100 mg, once daily) was studied in 12 HIV+ subjects. There was no effect on atazanavir/ritonavir pharmacokinetics, but abacavir AUC and Cmax decreased by 17% and 19%, respectively.

Abacavir plasma pharmacokinetics in the absence and presence of atazanavir/ritonavir or lopinavir/ritonavir and vice versa in HIV-infected patients. Waters L, Moyle G, Bonora S et al. Antivir Ther, 2007, 12(5): 825-830.

No Interaction Expected

Abacavir (ABC)

Atazanavir/cobicistat (ATV/c)

Quality of Evidence: Very Low

Summary:

Coadministration with atazanavir/cobicistat has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Coadministration of abacavir (600 mg once daily) and atazanavir/ritonavir (300/100 mg once daily) had no effect on atazanavir or ritonavir pharmacokinetics, but decreased abacavir AUC (17%) and Cmax (20%). These changes are unlikely to be clinically significant.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Coadministration of abacavir (600 mg, once daily) with atazanavir/ritonavir (300/100 mg, once daily) was studied in 12 HIV+ subjects. There was no effect on atazanavir/ritonavir pharmacokinetics, but abacavir AUC and Cmax decreased by 17% and 19%, respectively.

Abacavir plasma pharmacokinetics in the absence and presence of atazanavir/ritonavir or lopinavir/ritonavir and vice versa in HIV-infected patients. Waters L, Moyle G, Bonora S et al. Antivir Ther, 2007, 12(5): 825-830.

No Interaction Expected

Abacavir (ABC)

Atazanavir + ritonavir (ATV/r)

Quality of Evidence: Low

Summary:

Coadministration of abacavir (600 mg once daily) and atazanavir/ritonavir (300/100 mg once daily) had no effect on atazanavir or ritonavir pharmacokinetics, but decreased abacavir AUC (17%) and Cmax (20%). These changes are unlikely to be clinically significant.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

The coadministration of abacavir and Reyataz is not expected to significantly alter the exposure of abacavir.

Reyataz Summary of Product Characteristics, Bristol-Myers Squibb Pharmaceuticals Ltd, October 2018.

Coadministration of abacavir (600 mg, once daily) with atazanavir/ritonavir (300/100 mg, once daily) was studied in 12 HIV+ subjects. There was no effect on atazanavir/ritonavir pharmacokinetics, but abacavir AUC and Cmax decreased by 17% and 19%, respectively.

Abacavir plasma pharmacokinetics in the absence and presence of atazanavir/ritonavir or lopinavir/ritonavir and vice versa in HIV-infected patients. Waters L, Moyle G, Bonora S et al. Antivir Ther, 2007, 12(5): 825-830.

No Interaction Expected

Abacavir (ABC)

Atenolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as atenolol is mainly eliminated unchanged by the kidney, both by glomerular filtration and active secretion via the renal transporters OCT2 and MATE1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atorvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as atorvastatin is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atovaquone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as atovaquone is mainly eliminated unchanged in the faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atropine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination profiles of both drugs, there is little potential for interaction when atropine is used either systemically or as eye drops. Although metabolism of atropine is not fully elucidated, up to 50% is excreted unchanged via the kidneys. There is therefore little potential for clinically significant interactions with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Avanafil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avanafil is primarily metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Azathioprine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azathioprine is metabolized to 6-mercaptopurine which is further inactivated by xanthine oxidase and thiopurine methyltransferase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Azithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as azithromycin is mainly eliminated via biliary excretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Baclofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as baclofen is primarily eliminated by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Basiliximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Basiliximab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Beclometasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Beclometasone is a pro-drug which is not metabolised by CYP450 but is hydrolysed via esterase enzymes to the highly active metabolite beclometasone-17-monopropionate.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bedaquiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as bedaquiline is metabolised by CYP3A4 and mainly eliminated in faeces. There are no clinical data on the safety and efficacy of bedaquiline when coadministered with antiretroviral agents.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Belatacept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Belatacept is a protein that undergoes non-CYP mediated metabolism in the liver.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Benazepril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benazepril is rapidly hydrolyzed to its active metabolite benazeprilat which is eliminated predominantly renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bendroflumethiazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bendroflumethiazide is eliminated by hepatic metabolism (70%, exact pathway not known) and excreted unchanged in the urine (30%) via OAT1 and OAT3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Benserazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely as benserazide is hydrolysed to trihydroxybenzylhydrazine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Benznidazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Benznidazole undergoes non-CYP mediated metabolism and partly CYP mediated metabolism. Renal elimination of unchanged benznidazole appears to be minimal and there is little potential for an interaction via competition for renal elimination pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bepridil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as bepridil is mainly metabolized by CYP2D6 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Betahistine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Betahistine is metabolized by monoamine oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Betamethasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Betamethasone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Betrixaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as betrixaban is largely eliminated unchanged through biliary secretion via P-gp.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bevacizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely as bevacizumab is metabolized via proteolytic catabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bexarotene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Bexarotene is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bezafibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as half of bezafibrate dose is eliminated unchanged in the urine.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Quality of Evidence: Very Low

Summary:

Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint.

Description:

Biktarvy should not be co-administered with other antiretroviral medicinal products.

Biktarvy Summary of Product Characteristics, Gilead Sciences Ltd, June 2019.

As Biktarvy is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended.

Biktarvy Prescribing Information, Gilead Sciences Inc, August 2019.

No Interaction Expected

Abacavir (ABC)

Biperiden

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on limited information concerning the metabolism and clearance of biperiden, there is little potential for clinically significant interaction. Limited human data suggest biperiden undergoes hydroxylation in the liver.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bisacodyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bisacodyl is converted to an active metabolite by intestinal and bacterial enzymes. Absorption from the gastrointestinal tract is minimal and the small amount absorbed is excreted in the urine as the glucuronide.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bisoprolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bisoprolol is partly metabolized by CYP3A4 and CYP2D6 and partly eliminated unchanged in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Black cohosh (Actaea racemosa, Cimicifuga racemosa)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bleomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bleomycin is inactivated by a cytosolic enzyme, bleomycin hydrolase, and two thirds of the administered drug is excreted unchanged in urine, probably by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bortezomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bortezomib is mainly metabolized by CYP3A4 and 2C19 and to a lesser extent by CYPs 1A2, 2D6 and 2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bosentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as bosentan is metabolized by CYP3A4 and CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bromazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as bromazepam undergoes oxidative biotransformation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Budesonide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as budesonide is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bupivacaine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Bupivacaine is predominantly metabolized via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Buprenorphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Buprenorphine undergoes both N-dealkylation to form norbuprenorphine (via CYP3A4) and glucuronidation (via UGT2B7 and UGT1A1). Norbuprenorphine, an active metabolite, can further undergo glucuronidation (via UGT1A3 and UGT1A1).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bupropion (Amfebutamone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as bupropion is primarily metabolized by CYP2B6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Buspirone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as buspirone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Caffeine citrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as caffeine is mainly metabolized by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Calcium folinate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Calcium supplements

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Calcium is eliminated through faeces, urine and sweat.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Canagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Canagliflozin is primarily metabolised by UGT1A9 and UGT2B4 which are not affected by abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Candesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as candesartan is mainly eliminated unchanged via urine and bile.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cannabidiol (CBD)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cannabidiol is mainly metabolized by CYP3A4 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cannabis

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. THC, the principal psychoactive constituent of cannabis, is metabolized mainly by CYP2C9 and to a lesser extent by CYP3A4.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Capecitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Capecitabine is activated by sequential enzyme reactions to fluorouracil. Dihydropyrimidine dehydrogenase plays a role in fluorouracil metabolism. Nucleoside analogues such as abacavir may compete for these metabolic pathways. The clinical relevance of this interaction is unknown.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Capreomycin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Capreomycin is predominantly excreted via the kidneys as unchanged drug.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Captopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, based on metabolism and clearance a clinically significant interaction is unlikely as captopril is largely excreted in the urine (40-50% as unchanged drug, the rest as disulfide and other metabolites).

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Carbamazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but may increase carbamazepine concentrations due to competition for glucuronidation (carbamazepine is glucuronidated by UGT2B7). The clinical relevance of this interaction is unknown as the importance of glucuronidation in the overall metabolic process of carbamazepine is controversial.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Carbidopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carbidopa is partly metabolized and partly eliminated unchanged (30% of the total urinary excretion).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Carbimazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Carbimazole is a pro-drug which undergoes rapid and virtually complete metabolism to the active metabolite, thiamazole (also known as methimazole).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Carboplatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carboplatin is excreted primarily by renal glomerular filtration and therefore there is little potential for a pharmacokinetic interaction.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Carvedilol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carvedilol undergoes glucuronidation via UGTs 1A1, 2B4 and 2B7, with additional metabolism via CYP2D6 and to a lesser extent 2C9 and 1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Caspofungin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Caspofungin undergoes spontaneous chemical degradation and metabolism via a non CYP-mediated pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cat's Claw (Uncaria tomentosa)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cat’s claw was demonstrated to strongly inhibit CYP3A4 in vitro but has also been shown to induce CYP3A4 activity in vitro. No interaction is expected as abacavir does not undergo CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cefalexin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefalexin is predominantly eliminated unchanged renally by glomerular filtration and tubular secretion via OAT1 and MATE1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cefazolin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Cefazolin is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cefixime

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Cefixime is predominantly eliminated unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cefotaxime

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Cefotaxime is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ceftazidime

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Ceftazidime is predominantly eliminated unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ceftriaxone

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Ceftriaxone is eliminated mainly as unchanged drug; approximately 60% of the dose being excreted in the urine, almost exclusively by glomerular filtration, and the remainder via the biliary and intestinal tracts.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Celecoxib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as celecoxib is metabolised mainly by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cetirizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cetirizine is only metabolised to a limited extent and is eliminated unchanged in the urine through both glomerular filtration and tubular secretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cetuximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cetuximab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlorambucil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorambucil is almost completely metabolized (little is known about chlorambucil metabolism in humans, most probably non CYP mediated) and has extremely low urinary excretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chloramphenicol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Chloramphenicol is predominantly metabolized by glucuronidation mediated by UGT2B7, and abacavir is metabolised by both alcohol dehydrogenase and glucuronidation. There is little potential for a clinically significant interaction via competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlordiazepoxide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlordiazepoxide is extensively metabolized by hepatic microsomal enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chloroquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Chloroquine undergoes CYP mediated metabolism by CYPs 2C8, 3A4 and 2D6, and is also eliminated unchanged via the kidney (50%). Due to the multiple elimination pathways, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlorphenamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorphenamine is predominantly metabolized in the liver via CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlorpromazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlorpromazine is metabolized mainly by CYP2D6, but also CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlortalidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as chlortalidone is mainly excreted unchanged in the urine and faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ciclesonide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ciclesonide is a pro-drug activated by esterases in the lungs to des-ciclesonide which then undergoes CYP3A4-mediated metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ciclosporin (Cyclosporine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as ciclosporin is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cidofovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cidofovir is mainly eliminated unchanged renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cilazapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cilazapril is mainly eliminated unchanged by the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cimetidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cimetidine is eliminated primarily by the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ciprofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ciprofloxacin is primarily eliminated unchanged by the kidneys by glomerular filtration and tubular secretion via OAT3. It is also metabolized and partially cleared through the bile and intestine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cisapride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cisapride is metabolised mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cisatracurium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cisatracurium undergoes mainly (80% of overall elimination) spontaneous degradation in plasma and tissues at physiological pH and temperature (Hofmann elimination).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cisplatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cisplatin is eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Citalopram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Citalopram is metabolized by CYP2C19 (38%), 2D6 (31%) and 3A4 (31%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clarithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as clarithromycin is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clavulanic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Clavulanic acid is extensively metabolized (likely by a non CYP mediated pathway) and excreted in the urine by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clindamycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Clindamycin is metabolized by CYP3A4 with some metabolites having antibacterial activity.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clobazam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clobazam is metabolised by CYP3A4 (major) and CYP2B6 and CYP2C19 (minor) to the active metabolite N-desmethylclobazam, which is metabolised by CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clobetasol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely with the topical use of clobetasol.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clofazimine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Three clofazimine metabolites, two glucuronides, have been identified in urine, however clofazimine is largely excreted unchanged in the faeces, both as unabsorbed drug and via biliary excretion. As glucuronidation has a minor role in clofazimine elimination, interaction with abacavir via this mechanism is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clofibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clofibrate is hydrolyzed to an active metabolite, clofibric acid. Excretion of clofibric acid glucuronide is possibly performed via OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clomifene

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. CYP2D6 is thought to have a role in clomifene metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clomipramine (Chlorimipramine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clomipramine is metabolized by CYPs 3A4, 1A2 and 2C19 to desmethylclomipramine, an active metabolite which has a higher activity than the parent drug. In addition, clomipramine and desmethylclomipramine are metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clonazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clonazepam is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately 70% of administered clonidine is excreted in the urine, mainly in form of the unchanged parent drug (40-60% of the dose).

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Clopidogrel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Clopidogrel is a prodrug that is converted to its active metabolites via CYPs 3A4, 2B6, 2C19 and 1A2 and therefore no pharmacokinetic interaction is expected with abacavir. However, abacavir has been shown to potentiate platelet activation in vitro and thereby may reduce the pharmacodynamic effect of clopidogrel. A WHO Public Assessment Report for abacavir (but not the European or American product labels) advises that an alternative NRTI or antiplatelet agent should be considered.

Description:

Platelets were isolated from healthy, HIV-negative, donors and aggregation assessed in the presence of abacavir, tenofovir-DF (TDF) or tenofovir alafenamide (TAF). Abacavir significantly enhanced expression of platelet activation markers whereas TAF and TDF had no effect. These increases in the presence of abacavir demonstrate increased degranulation, indicating enhanced platelet activation and potentially a pro-thrombotic impact. Studies in mice showed normal platelet aggregation responses in the presence of TAF or TDF, whereas abacavir potentiated aggregation, again indicative of a pro-thrombotic effect.

Comparative impact of antiretrovirals on human platelet activation. Taylor K, Rauzi F, Smyth E, et al. Conference on Retroviruses and Opportunistic Infections (CROI), Boston, March 2018, abstract 673.

No Interaction Expected

Abacavir (ABC)

Clorazepate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clorazepate is rapidly converted to nordiazepam which is then metabolized to oxazepam by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cloxacillin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Cloxacillin is metabolised to a limited extent, and the unchanged drug and metabolites are excreted in the urine by glomerular filtration and renal tubular secretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clozapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clozapine is metabolized by CYPs 1A2, 2C19, 3A4, and to a lesser extent by CYPs 2C9 and 2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cocaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cocaine is metabolized by several pathways (non CYP and CYP mediated), with metabolism to norcocaine by CYP3A4 being less than 10% of the overall metabolic clearance.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Codeine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as codeine is glucuronidated by several UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Colchicine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely as colchicine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Colecalciferol (Vitamin D3) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with vitamin D when given with calcium or in a multivitamin preparation. Metabolism of vitamin D to active metabolites occurs in the liver and kidneys, and is thought to involve CYP3A4 and CYP24A1. There is little potential for interaction with abacavir via modulation of, or competition for, metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cubeb pepper (Piper cubeba)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. There is no evidence to suggest that Piper cubeba impacts UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cyanocobalamin (Vitamin B12) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with cyanocobalamin when given alone or in multivitamins. Cyanocobalamin undergoes enterohepatic recycling and is excreted almost entirely in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cyclophosphamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cyclophosphamide is activated (major pathway) to 4-hydroxycyclophosphamide by CYPs 2B6 (major), 2C9 and 3A4. Inactivation (minor, 10%) to the neurotoxic chloroacetaldehyde metabolite is performed mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cycloserine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Cycloserine is predominantly excreted renally via glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cyproterone acetate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cyproterone acetate is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cytarabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as cytarabine is metabolized by cytidine deaminase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dabigatran

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dabigatran is not metabolized by CYP450 isoenzymes and is mainly cleared by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dacarbazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dacarbazine undergoes activation to MTIC primarily via CYP1A2 and to a lesser extent by CYP2E1, with CYP1A1 having a role in extrahepatic metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Daclatasvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely as abacavir is metabolised by UGTs. No dose adjustment of daclatasvir or abacavir is required.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dactinomycin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dalteparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but a clinically significant pharmacokinetic interaction is unlikely. Dalteparin is excreted largely unchanged by the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dapagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapagliflozin is primarily metabolised by UGT1A9 which is not affected by abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dapsone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Darifenacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darifenacin is metabolized by CYP3A4 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Darunavir/cobicistat (DRV/c)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Based on the different elimination pathways of abacavir, for which metabolism is not mediated by CYP, no interactions are expected for this medicinal compound and darunavir/cobicistat. Darunavir/cobicistat can be used with this NRTI without dose adjustment.

Rezolsta Summary of Product Characteristics, Janssen-Cilag Ltd, July 2023.

Clinically relevant drug-drug interactions are not anticipated with concomitant use of darunavir and cobicistat with abacavir.

Prezcobix US Prescribing Information, Janssen Pharmaceuticals Inc, March 2023.

Potential Weak Interaction

Abacavir (ABC)

Darunavir/Cobicistat/ Emtricitabine/Tenofovir alafenamide (DRV/c/FTC/TAF)

Quality of Evidence: Very Low

Summary:

Symtuza (darunavir, cobicistat, emtricitabine, tenofovir alafenamide) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Darunavir + ritonavir (DRV/r)

Quality of Evidence: Very Low

Summary:

Coadministration of abacavir (600 mg once daily) and darunavir/ritonavir (900/100 mg once daily) decreased abacavir AUC, Cmax and Cmin by 27%, 22% and 38%, respectively (n=19). Based on the different elimination pathways (abacavir metabolism is not mediated by CYP450), no significant interactions are expected with darunavir/ritonavir. However, studies are required to relate the change in plasma abacavir exposure to the active intracellular carbovir triphosphate.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Coadministration has not been studied. Based on the different elimination pathways of abacavir for which metabolism is not mediated by CYP450, no interactions are expected for this medicinal compound and boosted darunavir. Boosted darunavir can be used with this NRTI without dose adjustment.

Prezista Summary of Product Characteristics, Janssen-Cilag Ltd, September 2022.

No dosage adjustments are recommended when darunavir/ritonavir is co-administered with abacavir.

Prezista Prescribing Information, Janssen Pharmaceuticals Inc, March 2023.

The steady-state pharmacokinetics of abacavir (600 mg once daily, plus two NRTIs – excluding tenofovir) were investigated when coadministered with darunavir/ritonavir (900/100 mg once daily) to 19 HIV+ subjects in a cross-over study. Abacavir AUC, Cmax and Cmin decreased by 27%, 22% and 38%, respectively in the presence of darunavir/ritonavir. Exposure of abacavir’s active intracellular carbovir triphosphate anabolite was decreased, however, the clinical significance of this decrease is unclear.

Pharmacokinetics of abacavir and its anabolite carbovir triphosphate without and with darunavir/ritonavir or raltegravir in HIV-infected subjects. Jackson A, Moyle, G, Dickinson L, et al. Antivir Ther, 2012, 17(1): 19-24.

No Interaction Expected

Abacavir (ABC)

Dasatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Dasatinib is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Daunorubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Delamanid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Delamanid is primarily metabolised by albumin to DM-6705; metabolism of DM-6705 to other metabolites is thought to involve pathways mediated by CYP enzymes, including CYP3A4. Abacavir does not affect CYP enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Denosumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Denosumab is not eliminated via hepatic metabolism but follows the immunoglobulin clearance pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desflurane is almost exclusively eliminated unchanged by the lungs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as desipramine is metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desogestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a desogestrel-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desogestrel is a prodrug which is activated to etonogestrel by CYP2C9 (and possible CYP2C19); the metabolism of etonogestrel is mediated by CYP3A4. Ethinylestradiol is mainly metabolized by hydroxylation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desogestrel (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a desogestrel-containing progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desogestrel is a prodrug which is activated to etonogestrel by CYP2C9 (and possible CYP2C19); the metabolism of etonogestrel is mediated by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dexmedetomidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexmedetomidine undergoes extensive hepatic metabolism through direct glucuronidation (mainly via UGT1A4, 2B10) and cytochrome P450 (mainly CYP2A6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dextropropoxyphene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as dextropropoxyphene is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diamorphine (diacetylmorphine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diamorphine is rapidly metabolized by sequential deacetylation to morphine which is then mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diazepam is metabolized to nordiazepam (by CYP3A4 and 2C19) and to temazepam (mainly by CYP3A4).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diclofenac

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Diclofenac is partly glucuronidated by UGT2B7 and partly oxidized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diethylcarbamazine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on limited data concerning the metabolism/elimination and toxicity profile of diethylcarbamazine, there is little potential for interaction with abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Digoxin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Digoxin is eliminated unchanged in the kidney via the renal transporters OATP4C1 and P-gp.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dihydrocodeine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely in the range of observed clinical concentrations as dihydrocodeine is glucuronidated by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dihydroergotamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as dihydroergotamine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diloxanide

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Diloxanide furoate is largely hydrolysed under the combined action of bacterial and gut esterases and consequently glucuronidated. No clinically-significant drug interactions are known, and significant interactions with antiretrovirals are unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diltiazem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as diltiazem is metabolized by CYP3A4 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Diphenhydramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Diphenhydramine is mainly metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dipyridamole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dipyridamole is glucuronidated by many UGTs, specifically those of the UGT1A subfamily.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Disopyramide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Disopyramide is metabolized by CYP3A4 (25%) and 50% of the drug is eliminated unchanged in the urine.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Disulfiram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but may increase abacavir concentrations due to inhibition of alcohol dehydrogenase by disulfiram. No a priori dosage adjustment is required as abacavir has a large therapeutic index.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Docetaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as docetaxel is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dofetilide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as dofetilide is mainly excreted unchanged in urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dolasetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Dolasetron is converted by carbonyl reductase to its active metabolite, hydrodolasetron, which is mainly glucuronidated (60%) and metabolized by CYP2D6 (10-20%) and CYP3A4 (<1%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dolutegravir (DTG)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely.

Description:

(See Summary)

Do Not Coadminister

Abacavir (ABC)

Dolutegravir/Abacavir/ Lamivudine (DTG/ABC/3TC)

Quality of Evidence: Very Low

Summary:

Triumeq (dolutegravir, abacavir, lamivudine) is indicated for use as a complete regimen for the treatment of HIV-1 infection. Triumeq contains abacavir and should not be taken with additional abacavir.

Description:

Triumeq should not be taken with any other medicinal products containing dolutegravir, abacavir, or lamivudine.

Triumeq Summary of Product Characteristics, ViiV Healthcare, June 2019.

Potential Weak Interaction

Abacavir (ABC)

Dolutegravir/Lamivudine (DTG/3TC)

Quality of Evidence: Very Low

Summary:

Dovato (dolutegravir/lamivudine) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment with abacavir is needed, dolutegravir and lamivudine are available coformulated with abacavir as a fixed dose combination (Triumeq).

Description:

Dovato is a complete regimen for the treatment of HIV-1 infection; therefore, coadministration with other antiretroviral drugs for the treatment of HIV-1 infection is not recommended.

Dovato US Prescribing Information, ViiV Healthcare, April 2019.

Potential Weak Interaction

Abacavir (ABC)

Dolutegravir/Rilpivirine (DTG/RPV)

Quality of Evidence: Very Low

Summary:

Juluca (dolutegravir/rilpivirine) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint as no clinically relevant drug-drug interaction is expected.

Description:

Juluca should not be administered with other antiretroviral medicinal products for the treatment of HIV.

Juluca Summary of Product Characteristics, ViiV Healthcare Ltd, May 2018.

Because Juluca is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended.

Juluca US Prescribing Information, ViiV Healthcare Ltd, September 2018.

No Interaction Expected

Abacavir (ABC)

Domperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as domperidone is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dopamine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Dopamine is metabolised in the liver, kidneys, and plasma by monoamine oxidase (MAO) and catechol-O-methyltransferase to inactive compounds. About 25% of a dose of dopamine is metabolised to norepinephrine within the adrenergic nerve terminals. There is little potential for dopamine to affect disposition of antiretrovirals, or to be affected if co-administered with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Doravirine (DOR)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doravirine is metabolized by CYP3A4. Abacavir does not interfere with CYP450 mediated metabolism.

Description:

Co-administration has not been studied but no effect on doravirine or abacavir is expected. No dose adjustment is required.

Pifeltro Summary of Product Characteristics, Merck Sharp & Dohme Ltd, November 2018.

Potential Weak Interaction

Abacavir (ABC)

Doravirine/Lamivudine/ Tenofovir-DF (DOR/3TC/TDF)

Quality of Evidence: Very Low

Summary:

Delstrigo (doravirine, lamivudine, tenofovir-DF) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint. Coadministration of abacavir with doravirine or lamivudine has not been studied, but a clinically significant interaction is unlikely. Coadministration of abacavir (300 mg single dose) and tenofovir-DF (300 mg once daily) had no effect on tenofovir AUC or Cmax, and abacavir AUC; abacavir Cmax increased by 12%.

Description:

Delstrigo is a complete regimen for the treatment of HIV-1 infection; therefore, Delstrigo should not be administered with other antiretroviral medicinal products.

Delstrigo Summary of Product Characteristics, Merck Sharp & Dohme Ltd, November 2018.

Because Delstrigo is a complete regimen for the treatment of HIV-1 infection, co-administration with other antiretroviral medications for treatment of HIV-1 infection is not recommended.

Delstrigo US Prescribing Information, Merck & Co Inc, August 2018.

No Interaction Expected

Abacavir (ABC)

Doxazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as doxazosin is metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Doxepin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxepin is metabolized mainly by CYP2C19 to nordoxepin, an active metabolite. In addition, doxepin and nordoxepin are metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Doxorubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Doxorubicin is mainly eliminated in the bile by P-gp and BCRP and does not undergo CYP-mediated metabolism. (Some product labels suggest doxorubicin is a substrate of CYP3A4, however, there are no strong data supporting the role of CYP3A4 in doxorubicin metabolism.)

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Doxycycline

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. No significant metabolism of doxycycline occurs, it is cleared intact by renal and biliary mechanisms.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Droloxifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as droloxifene is mainly glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dronabinol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dronabinol is mainly metabolized by CYP2C9 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Drospirenone (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a drospirenone-containing combined oral contraceptive (COC) has not been studied. Drospirenone is metabolized to a minor extent via CYP3A4. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Drospirenone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with drospirenone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drospirenone is metabolized to a minor extent via CYP3A4. Abacavir does not interact with this metabolic pathway. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dulaglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as dulaglutide is presumed to be degraded by general protein catabolism pathways. Dulaglutide delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products. However, interaction studies did not result in any clinically relevant effects and no dose adjustment of comedications is recommended.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Duloxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dutasteride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as dutasteride is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dydrogesterone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with dydrogesterone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dydrogesterone is metabolized to dihydrodydrogesterone (possibly via CYP3A4). Abacavir does not interact with this metabolic pathway. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Echinacea

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ecstasy (MDMA)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. MDMA is metabolized mainly by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Edoxaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Edoxaban is minimally metabolised by hydrolysis (mediated by carboxylesterase 1), conjugation, or oxidation by CYP3A4/5 (<10%). Edoxaban is eliminated primarily as unchanged drug in urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Efavirenz (EFV)

Quality of Evidence: Low

Summary:

Specific interaction studies have not been performed with efavirenz and abacavir. Clinically significant interactions would not be expected with abacavir since the NRTIs are metabolised via a different route than efavirenz and would be unlikely to compete for the same metabolic enzymes and elimination pathways. Abacavir had no effect on efavirenz pharmacokinetics when abacavir, efavirenz and indinavir were coadministered.

Description:

Specific interaction studies have not been performed with efavirenz and NRTIs other than lamivudine, zidovudine, and tenofovir disoproxil fumarate. Clinically significant interactions are not expected since the NRTIs are metabolised via a different route than efavirenz and would be unlikely to compete for the same metabolic enzymes and elimination pathways. No dosage adjustment is necessary for either medicinal product.

Sustiva Summary of Product Characteristics, Bristol-Myers Squibb Pharmaceuticals Ltd, May 2023.

No dosage adjustment is recommended when SUSTIVA is given with abacavir.

Efavirenz US Prescribing Information, Aurobindo Pharma Limited, October 2021.

The effect of abacavir (300 mg twice daily) on the pharmacokinetics of indinavir was assessed in HIV+ subjects receiving indinavir 1000 mg three times daily with efavirenz 600 mg once daily, or indinavir/efavirenz 1200/300 mg twice daily. Abacavir did not influence the pharmacokinetics or exposure parameters of either indinavir or efavirenz.

Indinavir, efavirenz and abacavir pharmacokinetics in human immunodeficiency virus-infected subjects. DiCenzo R, Forrest A, Squires KE, et al. Antimicrob Agents Chemother, 2003, 47: 1929-1935.

No Interaction Expected

Abacavir (ABC)

Eflornithine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Eflornithine is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Elbasvir/Grazoprevir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolised by UGT, which is not expected to be affected by elbasvir/grazoprevir, and is renally cleared.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eltrombopag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Eltrombopag is metabolised by cleavage conjugation (UGTs 1A1 and 1A3) and oxidation (CYPs 1A2 and 2C8).

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Elvitegravir/Cobicistat/ Emtricitabine/Tenofovir alafenamide (EVG/c/FTC/TAF)

Quality of Evidence: Very Low

Summary:

Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint.

Description:

Genvoya should not be co-administered with other antiretroviral medicinal products.
Genvoya Summary of Product Characteristics, Gilead Sciences International Ltd, November 2021.

Genvoya is a complete regimen for the treatment of HIV-1 infection; therefore, coadministration of Genvoya with other antiretroviral medications for treatment of HIV-1 infection should be avoided.

Genvoya US Prescribing Information, Gilead Sciences Inc, September 2021.

Potential Weak Interaction

Abacavir (ABC)

Elvitegravir/Cobicistat/ Emtricitabine/Tenofovir-DF (EVG/c/FTC/TDF)

Quality of Evidence: Very Low

Summary:

Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir-DF) is indicated for use as a complete regimen for the treatment of HIV 1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint. Based on metabolism and clearance a clinically significant interaction with elvitegravir/cobicistat or emtricitabine is unlikely. Coadministration of tenofovir-DF (300 mg once daily) and abacavir (300 mg single dose) had no effect on abacavir AUC but Cmax increased by 12%. A similar increase in abacavir Cmax may occur with elvitegravir/cobicistat/emtricitabine/tenofovir-DF.

Description:

Stribild is indicated for use as a complete regimen for the treatment of HIV 1 infection and must not be administered with other antiretroviral products.
Stribild Summary of Product Characteristics, Gilead Sciences International Ltd, November 2021.

Stribild is a complete regimen for the treatment of HIV-1 infection; therefore, Stribild should not be administered with other antiretroviral medications for treatment of HIV-1 infection.

Stribild Prescribing Information, Gilead Sciences Inc, September 2021.

Healthy volunteers (n=24) were administered a single dose of abacavir (600 mg) and elvitegravir/ritonavir (200/100 mg once daily) alone and in combination. Elvitegravir/ritonavir did not have significant effects on the kinetics of abacavir (AUC decreased by 16%, Cmax decreased by 12%). Elvitegravir AUC and Cmax decreased by 3% and 5%, with Cmin increasing by 6%.

Pharmacokinetics of coadministered ritonavir-boosted elvitegravir and zidovudine, didanosine, stavudine, or abacavir. Ramanathan S, Shen G, Hinkle J, et al. J Acquir Immune Defic Syndr, 2007, 46(2):160-6.

No Interaction Expected

Abacavir (ABC)

Empagliflozin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Empagliflozin is mainly glucuronidated by UGTs 1A3, 1A8, 1A9 and 2B7. It is a substrate of P-gp and BCRP, and also a substrate of the renal transporter OAT3 and the hepatic transporters OATP1B1 and OATP1B3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Emtricitabine (FTC)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Emtricitabine/Tenofovir alafenamide (FTC/TAF)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. A high rate of virological failure and emergence of resistance have been reported with once daily regimens of abacavir with lamivudine and tenofovir-DF; the same problems may be seen if Descovy is administered with a third nucleoside analogue.

Description:

There have been reports of a high rate of virological failure and of emergence of resistance at an early stage when tenofovir disoproxil fumarate was combined with lamivudine and abacavir as well as with lamivudine and didanosine as a once daily regimen. Therefore, the same problems may be seen if Descovy is administered with a third nucleoside analogue.

Descovy Summary of Product Characteristics, Gilead Sciences Ltd, April 2022.

Potential Weak Interaction

Abacavir (ABC)

Emtricitabine/Tenofovir-DF (FTC/TDF, PrEP)

Quality of Evidence: Very Low

Summary:

Coadministration with emtricitabine/tenofovir-DF has not been studied. Based on metabolism and clearance a clinically significant interaction with emtricitabine is unlikely. Coadministration of tenofovir-DF (300 mg once daily) and abacavir (300 mg single dose) had no effect on tenofovir AUC or Cmax, and abacavir AUC; abacavir Cmax increased by 12%. A similar increase in abacavir Cmax may occur with emtricitabine/tenofovir-DF. A high rate of virological failure and emergence of resistance have been reported when lamivudine was combined with tenofovir-DF and abacavir as a once daily regimen. A similar outcome is anticipated if emtricitabine/tenofovir-DF is combined with a third NRTI.

Description:

There have been reports of a high rate of virological failure and of emergence of resistance at an early stage in HIV-1 infected patients when tenofovir disoproxil was combined with lamivudine and abacavir as well as with lamivudine and didanosine as a once daily regimen. There is close structural similarity between lamivudine and emtricitabine and similarities in the pharmacokinetics and pharmacodynamics of these two agents. Therefore, the same problems may be seen if Truvada is administered with a third nucleoside analogue.

Truvada Summary of Product Characteristics Gilead Sciences Ltd, June 2018.

Coadministration of abacavir (300 mg once daily) and tenofovir-DF (300 mg once daily) increased abacavir Cmax by 12%, but had no effect on AUC (n=8).

Truvada US Prescribing Information, Gilead Sciences Inc, May 2018.

No Interaction Expected

Abacavir (ABC)

Enalapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enalapril is hydrolysed to enalaprilat which is eliminated renally, possibly via OATs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as enflurane is predominantly metabolized by CYP2E1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enoxaparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enoxaparin does not undergo cytochrome metabolism but is desulphated and depolymerised in the liver, and is excreted predominantly renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Entecavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Entecavir is eliminated renally via glomerular filtration and active renal secretion by both organic anion and cation transporters.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ephedrine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Ephedrine is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Epirubicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as epirubicin is glucuronidated by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eplerenone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as eplerenone is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Epoprostenol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Epoprostenol is rapidly hydrolyzed in the blood.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eprosartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as eprosartan is largely excreted in bile and urine as unchanged drug.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ergometrine (Ergonovine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Ergometrine is extensively metabolized, most likely by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ergotamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Ergotamine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Erlotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Erlotinib is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ertapenem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied significant drug interaction is unlikely. Ertapenem is mainly eliminated through the kidneys by glomerular filtration with tubular secretion playing a minor role.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Erythromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erythromycin is extensively metabolized in the liver.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Escitalopram

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eslicarbazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eslicarbazepine is a weak/moderate inducer of glucuronidation but is unlikely to cause a significant interaction since abacavir is only partly metabolized by glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Esomeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as esomeprazole is mainly metabolized by CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Estazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Estazolam is metabolized to its major metabolite 4-hydroxyestazolam via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Estradiol

Quality of Evidence: Very Low

Summary:

Coadministration with estradiol as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Estradiol is metabolized by CYP3A4, CYP1A2 and is glucuronidated. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Estramustine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Estramustine phosphate undergoes rapid dephosphorylation to estramustine which is then oxidized by 17beta-hydroxysteroid dehydrogenases to estromustine. Estramustine and estromustine are subsequently hydrolyzed to estradiol and estrone, respectively. Estradiol is then hydroxylated by CYPs 1A1, 1A2 and 3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ethambutol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethambutol is partly metabolized by alcohol dehydrogenase (20%) and partly eliminated unchanged in the faeces (20%) and in the urine (50%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ethinylestradiol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ethinylestradiol is mainly metabolized by hydroxylation. Note, use of ethinylestradiol as part of gender affirming treatment is not recommended due to thrombotic risks.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ethionamide

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Ethionamide is extensively metabolized in the liver, animal studies suggest involvement of flavin-containing monooxygenases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ethosuximide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as ethosuximide is mainly oxidized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etidocaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as etidocaine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etonogestrel (implant)

Quality of Evidence: Very Low

Summary:

Coadministration with an etonogestrel-containing progestogen-only implant has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etonogestrel is metabolized by CYP3A4. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etonogestrel (vaginal ring)

Quality of Evidence: Very Low

Summary:

Coadministration with etonogestrel as a combined vaginal ring (CVR) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etonogestrel is metabolized by CYP3A4. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etoposide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etoposide is partly glucuronidated by UGT1A1 and partly metabolized by CYP3A4 to reactive catechol metabolites. Conversion to reactive metabolites can also be mediated by prostaglandin synthase or myeloperoxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etravirine (ETR)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but no interaction is expected. Etravirine can be used without dose adjustment.

Description:

Coadministration has not been studied, but no interaction is expected based on the primary renal elimination route for abacavir, emtricitabine, lamivudine, stavudine and zidovudine. Etravirine can be used with these NRTIs without dose adjustment.
Intelence Summary of Product Characteristics, Janssen-Cilag Ltd, March 2019.

No Interaction Expected

Abacavir (ABC)

Eucalyptus globulus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. There is no evidence to suggest that eucalyptus impacts UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Everolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Everolimus is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Evolocumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Evolocumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Exemestane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Exemestane is metabolized by CYP3A4 and aldoketoreductase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Exenatide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as exenatide is primarily eliminated by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ezetimibe

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ezetimibe is glucuronidated by UGTs 1A1 and 1A3 and to a lesser extent by UGTs 2B15 and 2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Famciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Famciclovir is converted to penciclovir by aldehyde oxidase. Penciclovir is secreted in the urine possibly by OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Famotidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Famotidine is eliminated by renal excretion via OAT3 (65-70%) and by metabolic routes (30-35%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Felodipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as felodipine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fenofibrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fenofibrate is hydrolyzed to an active metabolite, fenofibric acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fentanyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fentanyl undergoes extensive CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fesoterodine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fesoterodine is rapidly hydrolysed to its active metabolite which is subsequently metabolized by CYP2D6 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fexofenadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fexofenadine undergoes negligible metabolism and is mainly eliminated unchanged in the faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Finasteride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Finasteride is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fish oils

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flecainide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flecainide is metabolized mainly via CYP2D6, with a proportion (approximately 30%) of the parent drug also eliminated unchanged renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flibanserin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flibanserin is primarily metabolized by CYP3A4 and to a lesser extent by CYP2C19.

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Flucloxacillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely as flucloxacillin is mainly eliminated renally. However, HLA-5701 has been identified as the main genetic risk factor for flucloxacillin induced liver injury and patients should be genotyped before receiving either drug.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluconazole is mainly eliminated renally by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flucytosine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flucytosine is metabolised to 5-flurouracil which is further metabolised by dihydropyrimidine dehydrogenase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fludarabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fludarabine phosphate is rapidly hydrolyzed (non-CYP mediated) to 2F-ara-A, the principal metabolite, which is then eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fludrocortisone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fludrocortisone is metabolized in the liver to inactive metabolites, possibly via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flunisolide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flunisolide undergoes CYP3A4-mediated metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flunitrazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flunitrazepam is metabolized mainly via CYP3A4 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluocinolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely with the topical use of fluocinolone.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Fluorouracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Fluorouracil is metabolised via the same mechanisms as endogenous uracil, including via dihydropyrimidine dehydrogenase. Nucleoside analogues such as abacavir may compete for this metabolic pathway. The clinical relevance of this interaction is unknown.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluoxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluoxetine is metabolized by CYPs 2D6 and 2C9 and to a lesser extent by 2C19 and 3A4 to form norfluoxetine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluphenazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fluphenazine is metabolised by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flurazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as the metabolism of flurazepam is most likely CYP-mediated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluticasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as fluticasone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as fluvastatin is metabolised mainly by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fluvoxamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Folic acid [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Folic acid is metabolized to dihydrofolic acid and tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide and folate reductases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Folic acid [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely when folic acid is administered in a multivitamin preparation. Folic acid is metabolized to dihydrofolic acid and tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide and folate reductases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fondaparinux

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fondaparinux does not undergo cytochrome metabolism but is eliminated predominantly renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Formestane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Formestane undergoes reductive metabolism by hepatic hydroxysteroid dehydrogenase and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Formoterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Formoterol is eliminated primarily by direct glucuronidation, with O-demethylation (by CYPs 2D6, 2C19, 2C9, and 2A6) followed by further glucuronidation being another pathway. As multiple CYP450 and UGT enzymes catalyze the transformation the potential for a pharmacokinetic interaction is low.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Foscarnet

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as foscarnet is cleared mainly by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fosinopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fosinopril is hydrolysed by esterases in the GI mucosa and liver.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Furosemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Furosemide is glucuronidated mainly in the kidney (UGT1A9) and to a lesser extent in the liver (UGT1A1). A large proportion of furosemide is also eliminated unchanged renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gabapentin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as gabapentin is cleared mainly by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ganciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ganciclovir is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporter OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Garlic

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Although garlic has been shown to induce intestinal CYP3A4 and/or P-gp, this is not expected to impact abacavir exposure.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gefitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Gefitinib is metabolized by CYP3A4 and 2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gemcitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gemcitabine is metabolized in the liver by cytidine deaminase to an inactive metabolite.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gemfibrozil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as gemfibrozil is metabolised mainly by UGT2B7. Although abacavir is partly glucuronidated, an interaction due to competition for glucuronidation is unlikely since several UGTs are involved in gemfibrozil metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gentamicin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Gentamicin is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gestodene (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a gestodene-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gestodene is metabolized by CYP3A4 and to a lesser extent by CYP2C9 and CYP2C19. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

GHB (Gamma-hydroxybutyrate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant interaction is unlikely. Gamma-hydroxybutyrate undergoes first pass metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ginger (Zingiber officinale)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. There is no evidence to suggest that ginger inhibits or induces UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ginkgo biloba

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glecaprevir/Pibrentasvir

Quality of Evidence: Low

Summary:

Coadministration has not been studied with abacavir alone but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolised by alcohol dehydrogenase and UGT, which is not expected to be affected by glecaprevir/pibrentasvir, and is renally cleared. Glecaprevir/pibrentasvir and abacavir was evaluated as part of a Phase 1 study with Triumeq (abacavir/dolutegravir/lamivudine) and showed no clinically significant interactions.

Description:

The pharmacokinetics of glecaprevir/pibrentasvir (300/120 mg once daily) coadministered with abacavir/dolutegravir/lamivudine (600/50/300 mg once daily) was studied in 24 healthy subjects. Cmax and AUC for glecaprevir and pibrentasvir decreased by 25-28%, but there was no impact on Cmax and AUC for abacavir, dolutegravir or lamivudine. No dose adjustment is required when glecaprevir/pibrentasvir are coadministered with abacavir, dolutegravir and lamivudine.
Glecaprevir and pibrentasvir interactions with combination antiretroviral regimens. Kosloski MP, Dutta S, Viani RM, et al. Conference on Retroviruses and Opportunistic Infections, Seattle, February 2017, abstract 413.

No Interaction Expected

Abacavir (ABC)

Glibenclamide (Glyburide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glibenclamide is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gliclazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as gliclazide is metabolised by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glimepiride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as glimepiride is metabolised by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glipizide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as glipizide is mainly metabolized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glyceryl trinitrate (Nitroglycerin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glyceryl trinitrate is metabolised by aldehyde dehydrogenase-2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glycopyrronium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glycopyrronium bromide is mainly eliminated renally (active secretion via organic cation transporter) and is also partly hydroxylated via multiple CYPs. Inhibition or induction of its metabolism is unlikely to result in a significant change in exposure.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Goldenseal root (Hydrastis canadensis)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Goserelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Goserelin is mainly hydrolyzed.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Granisetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as granisetron is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Grapefruit juice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Although grapefruit juice inhibits CYP3A4, this is not expected to alter exposure of abacavir as its metabolism is not CYP-mediated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Griseofulvin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Griseofulvin undergoes glucuronidation, although this is not the sole route of metabolism. There is little potential for interactions via competition of griseofulvin with abacavir for glucuronidation pathways. In vitro studies using rat liver microsomes have shown that griseofulvin can inhibit glucuronidation of some substances, however the UGT isoforms affected are not known. As abacavir is also metabolised via alcohol dehydrogenase, there is little potential for clinically significant interaction

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Halofantrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Halofantrine is extensively metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Haloperidol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Haloperidol undergoes glucuronidation (UGT2B7>1A4, 1A9), carbonyl reduction as well as oxidative metabolism (CYP3A4, 2D6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Halothane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Halothane undergoes both oxidative and reductive metabolism by cytochromes. In vitro data have shown that oxidation occurs mainly via CYP2E1 and to a lesser extent CYP2A6 and reduction via CYP2A6 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Heparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Heparin is thought to be eliminated via the reticuloendothelial system.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Heroin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically relevant drug interaction is unlikely. When used illicitly, heroin is mainly injected or inhaled through the nose and goes directly in the bloodstream. Heroin is then rapidly deacetylated to 6-monoacetylmorhine (6-MAM) and subsequently to morphine by plasma and liver esterase, respectively. Morphine is mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1). Abacavir does not affect these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hops (Humulus lupulus)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro data indicate that extracts of hops activate PXR and thereby induce the expression of CYP3A4, CYP2B6 and MDR1 to a degree similar to that of St John's wort. However, a pharmacokinetic study with a standardised hop extract showed no clinically relevant effect on CYPs 2C9, 1A2, and 2D6 and suggested only minor induction of CYP3A4/5 (AUC of alprazolam, a CYP3A4/5 substrate, decreased by ~8%). No effect on abacavir is expected as its metabolism is not CYP-mediated.

Description:

A botanically authenticated and chemically standardized hop extract was tested for Phase I pharmacokinetic drug interactions. Sixteen peri- and postmenopausal women consumed the hop extract twice daily for 2 weeks, and the pharmacokinetics of tolbutamide, caffeine, dextromethorphan, and alprazolam were evaluated before and after supplementation as probe substrates for CYP2C9, CYP1A2, CYP2D6, and CYP3A4/5, respectively. AUCs were unaffected, except for alprazolam which decreased by 7.6% suggesting minor induction of CYP3A4/5. No enzyme inhibition was detected. According to FDA guidelines, this hop dietary supplement caused no clinically relevant pharmacokinetic interactions with respect to CYP2C9, CYP1A2, CYP2D6, or CYP3A4/5.

Pharmacokinetic interactions of a hop dietary supplement with drug metabolism in perimenopausal and postmenopausal women. van Breemen RB, Chen L, Tonsing-Carter A, et al. J Agric Food Chem, 2020, 68(18):5212-5220.

Hop extracts were examined both structurally and functionally and were found to induce the expression of drug metabolism and excretion proteins. mRNA levels for CYP3A4, CYP2B6 and MDR1 were increased in a concentration-dependent manner by activating PXR. The efficacy with which hops activated PXR was comparable to that of St John's wort.

Structural basis of human pregnane X receptor activation by the hops constituent colupulone. Teotico DG, Bischof JJ, Peng L, et al. Mol Pharmacol, 2008, 74:1512-1520.

No Interaction Expected

Abacavir (ABC)

Hydralazine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Hydralazine is metabolised via primary oxidative metabolism and acetylation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydrochlorothiazide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydrochlorothiazide is not metabolised and is cleared by the kidneys via OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydrocodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Hydrocodone is metabolised by CYP2D6 to hydromorphone and by CYP3A4 to norhydrocodone, both of which have analgesic effects.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydrocortisone (oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydrocortisone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydrocortisone (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but no clinically relevant drug interactions are expected with the topical use of hydrocortisone.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydromorphone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Hydromorphone is eliminated via glucuronidation, mainly by UGT2B7.

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Hydroxycarbamide (Hydroxyurea)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. However, hydroxyurea is not licensed for use in combination with stavudine and didanosine as toxicities including pancreatitis and hepatitis (in some cases fatal) in HIV patients have been reported via post marketing surveillance. Thus, caution and monitoring for side effects is recommended if coadministered with other NRTIs such as abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydroxyzine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hydroxyzine is partly metabolized by alcohol dehydrogenase and partly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ibalizumab-uiyk (IBA)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. No drug interaction studies have been conducted with ibalizumab: based on ibalizumab’s mechanism of action and target-mediated drug disposition, drug-drug interactions are not expected. Abacavir undergoes mostly hepatic metabolism whereas ibalizumab, a monoclonal antibody binding to the CD4 receptor, is likely to be eliminated via intracellular catabolism similarly to other monoclonal antibodies. Dose modifications of ibalizumab are not required when administered with any other antiretroviral.

Description:

No interaction studies have been performed. Based on the mechanism of action and target-mediated drug disposition of ibalizumab, it is not expected that ibalizumab will have pharmacokinetic drug-drug interactions with other medicinal products.

Trogarzo Summary of Product Characteristics, Theratechnologies International Ltd, September 2019.

No drug interaction studies have been conducted with ibalizumab-uiyk. Based on ibalizumab-uiyk’s mechanism of action and target-mediated drug disposition, drug-drug interactions are not expected. Dose modifications of ibalizumab-uiyk are not required when administered with any other antiretroviral.

Trogarzo US Prescribing Information, Theratechnologies Inc., May 2018.

No Interaction Expected

Abacavir (ABC)

Ibandronic acid (Ibandronate)

Quality of Evidence: Very Low

Summary:

Ibandronic acid should be taken after an overnight fast (at least 6 hours) and before the first food or drink of the day. Medicinal products and supplements should be similarly avoided prior to taking ibandronic acid. Fasting should be continued for at least 30 minutes after taking ibandronic acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ibuprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibuprofen is metabolized mainly by CYP2C9 and to a lesser extent by CYP2C8 and direct glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ifosfamide

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for pharmacokinetic interaction. Ifosfamide is predominantly metabolized by CYP3A4 and CYP2B6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iloperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Iloperidone is metabolised by CYP3A4 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iloprost

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iloprost is extensively metabolized via beta oxidation of the carboxyl side chain with only a minor role for CYP metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Imatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Imatinib is primarily metabolized by CYP3A4 and to a lesser extent by CYPs 1A2, 2D6, 2C9 and 2C19. In vitro data indicate that imatinib inhibits CYPs 3A4, 2D6, 2C9 and 2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Imipenem/Cilastatin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Renal clearance of unchanged drug occurs via glomerular filtration and to a lesser extent, active tubular secretion for both imipenem (when administered with cilastatin), and cilastatin.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Imipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Indacaterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indacaterol is eliminated partly unchanged (33%) and partly metabolized by CYP3A4 and UGT1A1, and is a weak substrate of P-gp. Abacavir does not interfere with indacterol metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Indapamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indapamide is extensively metabolized by CYP P450.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Insulin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Interferon alpha

Quality of Evidence: Very Low

Summary:

Hepatic decompensation (some fatal) has occurred in cirrhotic HIV/HCV co-infected patients receiving NRTI-containing HIV therapy and interferon alpha and ribavirin. Patients receiving interferon with ribavirin and NRTIs should be closely monitored for treatment-associated toxicities, especially hepatic decompensation and anaemia. Some data suggest that HIV/HCV co-infected patients receiving abacavir-containing ART may be at risk of a lower response rate to pegylated interferon/ribavirin therapy although this has not been confirmed in other studies.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Interleukin 2 (Aldesleukin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as interleukin-2 is mainly eliminated by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Inula racemosa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. There are no indications that Inula racemosa impacts UGTs or P-gp.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iodine [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with iodine when given alone or in multivitamins. Iodine is converted to iodide, which is trapped in the thyroid gland. Iodides are excreted mainly in the urine with smaller amounts excreted in the faeces, sweat and saliva.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ipratropium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. A small proportion of an inhaled ipratropium dose is systemically absorbed (6.9%). Metabolism is via ester hydrolysis and conjugation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Irbesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as glucuronidation is not the major contributor of irbesartan clearance.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Irinotecan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as irinotecan is glucuronidated by several UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iron supplements (oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Isoflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as isoflurane is almost exclusively eliminated unchanged by the lungs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Isoniazid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Isosorbide dinitrate

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Isosorbide dinitrate undergoes extensive first past metabolism, predominantly in the liver, with less than 30% of a dose undergoing subsequent glucuronidation. There is therefore little potential for clinically significant interaction with abacavir via competition for glucuronidation pathways.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Isotretinoin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Isotretinoin is metabolised mainly by CYP2C8 and CYP3A4 with the participation of CYP2B6 and CYP2C9. There is a possible interaction with abacavir given the common pathway of elimination via alcohol dehydrogenase. However, there are insufficient data to recommend dosage adjustment.

Description:

Retinoid compounds are eliminated via alcohol dehydrogenase. Interaction with abacavir is possible but has not been studied.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

No Interaction Expected

Abacavir (ABC)

Itraconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as itraconazole is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ivabradine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction as ivabradine is metabolised by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ivermectin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. In vitro studies suggest that ivermectin is predominantly metabolised by CYP3A4, whereas abacavir is metabolised via alcohol dehydrogenase and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Kanamycin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Kanamycin is predominantly eliminated unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ketamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Ketamine is mainly metabolized by CYP3A4 and to a lesser extent by CYP2B6 and CYP2C9 in the range of concentrations used in anaesthesia.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ketoconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as ketoconazole is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Labetalol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Labetalol is mainly glucuronidated by UGTs 1A1 and 2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lacidipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as lacidipine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lacosamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lacosamide is metabolized to O-desmethyl-lacosamide mainly by CYP2C19 (~30% of the dose) and is eliminated unchanged through the kidneys (~40% of the dose).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lactulose

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of lactulose to lactic acid occurs via gastro-intestinal microbial flora only.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lamivudine (3TC)

Quality of Evidence: Moderate

Summary:

No significant pharmacokinetic interaction was observed in clinical studies. A high rate of virological failure and emergence of resistance reported when lamivudine was combined with tenofovir and abacavir as a once daily regimen. Note, the bioavailability of lamivudine solution has been shown to be significantly reduced in a dose dependent manner by sorbitol which is present in liquid formulations such as abacavir oral solution.

Description:

Clinical studies have shown that there are no clinically significant interactions between abacavir, zidovudine, and lamivudine. There have been reports of a high rate of virological failure and of emergence of resistance at an early stage when abacavir was combined with tenofovir disoproxil fumarate and lamivudine as a once daily regimen.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Fifteen HIV-infected patients were enrolled in a crossover-designed drug interaction trial evaluating single doses of abacavir (600 mg), lamivudine (150 mg), and zidovudine (300 mg) alone or in combination. Analysis showed no clinically relevant changes in the pharmacokinetics of abacavir with the addition of lamivudine or zidovudine or the combination of lamivudine and zidovudine. Lamivudine exposure (AUC decreased 15%) and zidovudine exposure (AUC increased 10%) did not show clinically relevant changes with concurrent abacavir.
Ziagen Prescribing Information, ViiV Healthcare, June 2019.

There have been reports of a high rate of virological failure and of emergence of resistance at an early stage when lamivudine was combined with tenofovir disoproxil fumarate and abacavir as well as with tenofovir disoproxil fumarate and didanosine as a once daily regimen. Coadministration of sorbitol solution (3.2 g, 10.2 g, 13.4 g) with a single 300 mg dose of lamivudine oral solution resulted in dose-dependent decreases of 14%, 32%, and 36% in lamivudine exposure (AUC) and 28%, 52%, and 55% in the Cmax of lamivudine in adults. When possible, avoid chronic coadministration of Epivir with medicinal products containing sorbitol. Consider more frequent monitoring of HIV-1 viral load when chronic coadministration cannot be avoided.
Epivir Summary of Product Characteristics, ViiV Healthcare UK Ltd, February 2019.

Coadministration of single doses of lamivudine and sorbitol resulted in a sorbitol dose-dependent reduction in lamivudine exposures. When possible, avoid use of sorbitol-containing medicines with lamivudine. Lamivudine and sorbitol solutions were coadministered to 16 healthy adult subjects in an open-label, randomized-sequence, 4-period, crossover trial. Each subject received a single 300-mg dose of lamivudine oral solution alone or coadministered with a single dose of 3.2 grams, 10.2 grams, or 13.4 grams of sorbitol in solution. Coadministration of lamivudine with sorbitol resulted in dose-dependent decreases of 20%, 39%, and 44% in the AUC(0-24), 14%, 32%, and 36% in the AUC(infinity), and 28%, 52%, and 55% in the Cmax; of lamivudine, respectively.
Epivir US Prescribing Information, ViiV Healthcare, May 2019.

The pharmacokinetics and safety of single doses of abacavir (600 mg), zidovudine (300 mg) and lamivudine (150 mg) were evaluated when given alone or with either or both of the other drugs to 13 HIV-infected subjects. Coadministration of abacavir with lamivudine (with or without zidovudine) decreased lamivudine AUC by ~15%, decreased Cmax by ~ 35% and delayed Tmax by ~1 h. While these changes are statistically significant, they are not considered to be clinically significant. There were no differences in the pharmacokinetics of abacavir when given alone, or with zidovudine or lamivudine, or with both zidovudine and lamivudine.
Single dose pharmacokinetics and safety of abacavir (1592U98), zidovudine, and lamivudine administered alone and in combination in adults with human immunodeficiency virus infection. Wang LH, et al. Antimicrob Agents Chemother, 1999, 43: 1708-1715.

The effect of sorbitol on the single dose pharmacokinetics of 3TC oral solution was evaluated in 16 HIV-negative subjects. Sorbitol had a dose-dependent effect on 3TC PK with decreases of 28%, 52%, and 55% in Cmax and decreases of 20%, 39%, and 44% in AUC when co-administered with 3.2 g, 10.2 g, and 13.4 g sorbitol, respectively.
Effect of sorbitol on 3TC PK after administration of lamivudine solution in adults. Adkinson KK, McCoig C, Wolstenholm A, et al. CROI 2017, Seattle USA, February 2017, abstract 428.

No Interaction Expected

Abacavir (ABC)

Lamotrigine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lamotrigine is mainly glucuronidated by UGT1A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lansoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lansoprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lapatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Lapatinib is metabolized by CYP3A4 and does not significantly inhibit renal transporters (OAT, OCT).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ledipasvir/Sofosbuvir

Quality of Evidence: Moderate

Summary:

Coadministration of abacavir (in combination with lamivudine) and ledipasvir/sofosbuvir had no effect on the pharmacokinetic parameters of abacavir, ledipasvir or sofosbuvir. Abacavir Cmax and AUC decreased by 8% and 10%; lamivudine Cmax and AUC decreased by 7% and 6% and Cmin increased by 12%. Ledipasvir Cmax, AUC and Cmin increased by 10%, 18% and 26%; sofosbuvir Cmax and AUC increased by 8% and 21%; AUC and Cmin of GS-331007 increased by 5% and 8% with no change in Cmax. No dose adjustment of ledipasvir/sofosbuvir or abacavir/ lamivudine is required.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lenalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenalidomide undergoes limited metabolism and is eliminated renally. Lenalidomide does not induce or inhibit UGTs, or inhibit renal transporters.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lercanidipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lercanidipine is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Letrozole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Letrozole is metabolised by CYP3A4 and CYP2A6 to carbinol, an inactive metabolite.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Leuprorelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Leuprorelin acetate is a peptide that is primarily degraded by peptidases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levamisole (Ergamisol)

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Metabolism and elimination of levamisole has not been well characterized. Based on limited information, and single dose use of levamisole, clinically significant interactions are not considered likely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levetiracetam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Levetiracetam undergoes enzymatic hydrolysis (non CYP) and is eliminated unchanged in the urine by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levocetirizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as less than 14% of a dose of levocetirizine is metabolised. Levocetirizine is mainly eliminated unchanged in the urine through both glomerular filtration and tubular secretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levodopa

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. In the presence of a peripheral dopa-decarboxylase inhibitor (carbidopa or benserazide) levodopa is metabolised mainly to 3-O-methyldopa by catechol-O-methyltransferase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely as levofloxacin is metabolised to a very small extent.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levomepromazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely as levomepromazine is metabolised by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (Emergency Contraception)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with levonorgestrel as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Abacavir does not interact with these metabolic pathways. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (implant)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel progestogen-only implant has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (IUD)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel intra-uterine device (IUD) has not been studied but there is little potential for an interaction given the local mechanism of action of levonorgestrel.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levonorgestrel (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a levonorgestrel progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Levothyroxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Levothyroxine is metabolized by deiodination (by enzymes of deiodinase family) and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lidocaine (Lignocaine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. CYP1A2 is the predominant enzyme involved in lidocaine metabolism in the range of therapeutic concentrations with a minor contribution from CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Linagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as linagliptin is mainly eliminated as parent compound in faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Linezolid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Linezolid undergoes non-CYP mediated metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Liquorice (Glycyrrhiza glabra)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Liraglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as liraglutide is degraded by endogenous endopeptidases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lisinopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lisinopril is eliminated unchanged renally via glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lithium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lithium is mainly eliminated unchanged through the kidneys and is freely filtered at a rate that is dependent upon the glomerular filtration rate.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Loperamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Loperamide is mainly metabolized by CYP3A4 and CYP2C8.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Lopinavir/ritonavir (LPV/r)

Quality of Evidence: Low

Summary:

Coadministration of abacavir and lopinavir/ritonavir has no effect on lopinavir or ritonavir pharmacokinetics, but appears to decrease abacavir exposure by ~30%. The clinical significance of this is unknown.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Abacavir concentrations may be reduced due to increased glucuronidation by lopinavir. The clinical significance of this reduced abacavir concentrations is unknown.
Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021.

Lopinavir induces glucuronidation and therefore has the potential to reduce abacavir plasma concentrations. The clinical significance of this potential interaction is unknown.
Kaletra Prescribing Information, AbbVie Ltd, October 2020.

Plasma concentrations of abacavir (300 mg twice daily) with lopinavir/ritonavir (400/100 mg twice daily, n=7) or nevirapine (400 mg once daily, n=5) were determined in HIV positive patients. Abacavir AUC, Cmax and Ctrough were 40%, 46% and 29% lower, respectively, in the presence of lopinavir/ritonavir when compared to nevirapine. The authors suggest that the decrease in exposure of abacavir is due to induction of glucuronidation by ritonavir and/or lopinavir.
Pilot pharmacokinetic study of Human Immunodeficiency Virus-infected patients receiving tenofovir disoproxil fumarate (TDF): Investigation of systemic and intracellular interactions between TDF and abacavir, lamivudine, or lopinavir-ritonavir. Pruvost A, Negredo E, Théodoro F, et al. Antimicrob Agents Chemother, 2009, 53(5): 1937-1943.

Coadministration of abacavir (600 mg once daily) and lopinavir/ritonavir (400/100 mg twice daily) was studied in 12 HIV+ subjects. There was no effect on lopinavir or ritonavir pharmacokinetics, but abacavir AUC decreased by 32% and Cmax decreased by 34%.
Abacavir plasma pharmacokinetics in the absence and the presence of atazanavir/ritonavir or lopinavir/ritonavir) and vice versa in HIV+ patients. Waters L, et al. 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, February 2007, abstract 557.

No Interaction Expected

Abacavir (ABC)

Loratadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Loratadine is metabolized mainly by CYP3A4 and to a lesser extent by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lorazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as lorazepam is mainly glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lormetazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as lormetazepam is mainly glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Losartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as losartan is glucuronidated by several UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lovastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as lovastatin is metabolised mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

LSD (Lysergic acid diethylamide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. LSD (lysergic acid diethylamide) is metabolized to O-H-LSD and N-desmethyl-LSD partly by CYP (unknown isoenzyme).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lumefantrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as lumefantrine is metabolized predominantly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Macitentan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Macitentan is metabolized mainly by CYP3A4 and to a lesser extent by CYPs 2C19, 2C9 and 2C8.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Magnesium supplements

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Magnesium is eliminated in kidney, mainly by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Malabar nut tree (Justicia adhatoda, Adhatoda vasica)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the limited data available on the effect of malabar nut tree leaf extracts on drug metabolism, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mannitol

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Mannitol is metabolised only very slightly, if at all, to glycogen in the liver; it is predominantly eliminated unchanged via glomerular filtration. There is little potential for mannitol to affect the disposition of antiretrovirals, or to be altered if co-administered with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Maprotiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Maraviroc (MVC)

Quality of Evidence: Very Low

Summary:

No significant interaction expected. Maraviroc and NRTIs can be co-administered without dose adjustment.

Description:

No significant interaction expected. Maraviroc 300 mg twice daily and NRTIs can be co-administered without dose adjustment.
Celsentri Summary of Product Characteristics,ViiV Healthcare, September 2018.

The recommended dose of maraviroc when coadministered with NRTIs is 300 mg twice daily.
Selzentry Prescribing Information, ViiV Healthcare, July 2018

No Interaction Expected

Abacavir (ABC)

Mebendazole

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Medroxyprogesterone (depot injection)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Medroxyprogesterone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Medroxyprogesterone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with medroxyprogesterone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Medroxyprogesterone is metabolized by CYP3A4. Abacavir does not interaction with this pathway. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mefenamic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mefenamic acid is metabolized by CYP2C9 and glucuronidated by UGT2B7 and UGT1A9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mefloquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mefloquine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Megestrol acetate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as megestrol acetate is mainly eliminated in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Meglumine antimoniate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meglumine antimoniate is predominantly eliminated unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Melarsoprol

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on limited data concerning metabolism, elimination and toxicity of melarsoprol, there is little potential for interaction, although due to the lack of available data, vigilance is required if administering melarsoprol with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Menthol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. There is no evidence to suggest that menthol impacts UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mephedrone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction as mephedrone is metabolized mainly by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mercaptopurine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolic/toxicity profiles of both drugs, there is little potential for interaction. Mercaptopurine is predominantly metabolised by xanthine oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Meropenem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meropenem is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporters OAT3/OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mesalazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mesalazine is metabolized to N-acetyl-mesalazine by N-acetyltransferase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mesna

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolic/toxicity profiles of both drugs, there is little potential for interaction. Mesna is rapidly oxidised to its only metabolite, mesna disulphide via the physiological cysteine system. Approximately 32% and 33% of an administered dose is eliminated in the urine in 24 hours as mesna and mesna disulphide respectively.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Metformin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metformin is mainly eliminated unchanged in the urine via the renal transporter OCT2.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Methadone

Quality of Evidence: Low

Summary:

Coadministration of abacavir (600 mg twice daily) and methadone had no clinically significant effect on abacavir pharmacokinetics; methadone clearance increased by 22%. Clinical monitoring should be considered as methadone maintenance therapy may need to be adjusted in some patients.

Description:

In a pharmacokinetic study, coadministration of 600 mg abacavir twice daily with methadone showed a 35% reduction in abacavir Cmax and a one hour delay in tmax but the AUC was unchanged. The changes in abacavir pharmacokinetics are not considered clinically relevant. In this study abacavir increased the mean methadone systemic clearance by 22%. The induction of drug metabolising enzymes cannot therefore be excluded. Patients being treated with methadone and abacavir should be monitored for evidence of withdrawal symptoms indicating under dosing, as occasionally methadone re-titration may be required.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

The addition of methadone has no clinically significant effect on the pharmacokinetic properties of abacavir. In a study of 11 HIV-infected patients receiving methadone-maintenance therapy (40 mg and 90 mg daily), with 600 mg of abacavir twice daily (twice the currently recommended dose), oral methadone clearance increased 22% (90% CI 6% to 42%). This alteration will not result in a methadone dose modification in the majority of patients; however, an increased methadone dose may be required in a small number of patients. The addition of methadone had no clinically significant effect on the pharmacokinetic properties of abacavir.
Ziagen Prescribing Information, ViiV Healthcare, June 2019.

Methadone concentrations were determined in 5 patients receiving methadone maintenance therapy (12.5-112.5 mg per day) before and after the introduction of amprenavir (1200 mg bd) plus abacavir (600 mg twice daily). Coadministration resulted in a 35% (28-87%) decrease in methadone concentrations. Two patients reported a withdrawal reaction to opioids.
Methadone blood concentrations are decreased by the administration of abacavir plus amprenavir. Bart PA, et al. Ther Drug Monit, 2001, 23: 553-555.

No Interaction Expected

Abacavir (ABC)

Methamphetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methamphetamine is mainly metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methotrexate (Amethopterin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance there is little potential for an interaction. Methotrexate is predominantly eliminated unchanged via the kidneys, with minimal metabolism. Note, some methotrexate product labels contraindicate its use or advise caution in immunodeficiency and some contraindicate its use in HIV infection.

Description:

Methotrexate concentrations were determined in 43 HIV+ patients treated with ARVs and chemotherapy containing high dose methotrexate (3g/m2). Methotrexate elimination half-life was not affected by use of NNRTIs, integrase inhibitors or NRTIs (tenofovir /emtricitabine or abacavir/lamivudine).
The pharmacokinetics of high‑dose methotrexate in people living with HIV on antiretroviral therapy. Dalla Pria A, Bendle M, Ramaswami R, et al. Cancer Chemother Pharmacol, 2016, 77:653-657.

No Interaction Expected

Abacavir (ABC)

Methyldopa

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Methyldopa is excreted in urine largely by glomerular filtration, primarily unchanged and as the mono-O-sulfate conjugate. it is unlikely to affect the disposition of antiretrovirals, or to be altered by co-administration with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methylphenidate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Methylphenidate is not metabolized by cytochrome P450s to a clinically relevant extent and does not inhibit cytochrome P450s.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methylprednisolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Methylprednisolone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Metoclopramide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metoclopramide is partially metabolized by CYP450 system (mainly CYP2D6).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Metolazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely as metolazone is largely excreted unchanged in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Metoprolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metoprolol is mainly metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Metronidazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Although abacavir concentrations may increase due to inhibition of alcohol dehydrogenase by metronidazole, no a priori dosage adjustment is required as abacavir has a large therapeutic index.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mexiletine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mexiletine is metabolized mainly by CYP2D6 and to a lesser extent by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mianserin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Miconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Midazolam (oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midazolam is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Midazolam (parenteral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midazolam is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mifepristone

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. CYP3A4 is thought to be the main enzyme involved in mifepristone metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Milk thistle (Silybum marianum, silymarin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drug-drug interaction studies suggest that milk thistle has limited clinical impact on substrates of CYP3A, P-gp, UGT and OATP.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Milnacipran

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Milnacipran is mainly eliminated unchanged (50%), and as glucuronides (30%) and oxidative metabolites (20%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Miltefosine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on limited data concerning metabolism, elimination and toxicity of miltefosine, there is little potential for interaction. In vitro studies have shown that interactions between miltefosine and drugs which are metabolised by cytochrome P450, glucuronidated or otherwise conjugated are unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Minaxolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as minaxolone undergoes hepatic metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mirabegron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mirabegron is metabolized by multiple pathways including hydrolysis, glucuronidation and oxidation by CYP2D6 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mirtazapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mirtazapine is metabolised to 8-hydroxymirtazapine by CYP2D6 and CYP1A2, and to N-desmethylmirtazapine mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Misoprostol

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Misoprostol is predominantly metabolised via fatty acid oxidising systems.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mitoxantrone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Mitoxantrone is metabolized to inactive carboxylic acid derivatives possibly by CYP450.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Modafinil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Modafinil is largely metabolized by hydrolysis (esterase mediated) and to a lesser extent by CYP3A4 mediated oxidative metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mometasone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mometasone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Montelukast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Montelukast is mainly metabolized by CYP2C8 and to a lesser extent by CYPs 3A4 and 2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Morphine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically relevant drug interaction is unlikely. Morphine is mainly glucuronidated to morphine-3-glucuronide (UGT2B7>UGT1A1) and, to a lesser extent, to the pharmacologically active morphine-6-glucuronide (UGT2B7>UGT1A1). Abacavir does not affect this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Moxifloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moxifloxacin is predominantly glucuronidated by UGT1A1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Multivitamins

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Mycophenolate

Quality of Evidence: Moderate

Summary:

Mycophenolate mofetil is a prodrug of mycophenolic acid (MPA). MPA undergoes glucuronidation; coadministration of those NRTIs which are also glucuronidated (i.e. abacavir or zidovudine) could alter mycophenolate levels. Concentration monitoring of mycophenolate may be considered. Mycophenolate had no significant effect on abacavir plasma concentrations or intracellular phosphorylated metabolites.

Description:

The effect of mycophenolate (500 mg twice daily) on the pharmacokinetics of abacavir was studied in HIV-infected subjects receiving abacavir (300 mg twice daily), didanosine (400 mg once daily), lamivudine (150 mg twice daily), indinavir, ritonavir and nevirapine alone (n=10) and in combination with mycophenolate (n=9). The AUC and clearance of abacavir were not statistically significantly different in the two groups. Median Cmax values were 1.86 vs. 1.98 mg/L (alone vs. combination) and AUC values were 3.25 vs. 3.67 mg.h/L (alone vs. combination). There were no significant differences in intracellular concentrations of dGTP between the two groups.
Effect of mycophenolate mofetil on the pharmacokinetics of antiretroviral drugs and on intracellular nucleoside triphosphate pools. Sankatsing SUC, et al. Clin Pharmacokinet, 2004, 43; 823-832.

No Interaction Expected

Abacavir (ABC)

Naftidrofuryl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naftidrofuryl is metabolized to 3 major metabolites primarily by plasma pseudo-choline esterases

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Naloxone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naloxone is mainly glucuronidated by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Naltrexone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies have shown that neither naltrexone, nor its main metabolite (6-beta-naltrexol), is metabolized by CYP450 enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nandrolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nandrolone is metabolised in the liver by alpha-reductase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Naproxen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naproxen is mainly glucuronidated by UGT2B7 (major) and demethylated to desmethylnaproxen by CYP2C9 (major) and CYP1A.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nateglinide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nateglinide is metabolized mainly by CYP2C9 (70%) and to a lesser extent by CYP3A4 (30%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nebivolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nebivolol metabolism involves CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nefazodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nefazodone is metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Neostigmine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Neostigmine is thought to undergo a degree of hepatic metabolism, although the mechanisms are unknown. However, as metabolism also occurs via hydrolysis by cholinesterase and up to 50% of a dose is excreted unchanged via the kidneys, there is little potential for clinically significant interaction with antiretrovirals via modification of hepatic metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nevirapine (NVP)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely.

Description:

In human liver microsomes, abacavir did not inhibit cytochrome P450 isoforms. Nevirapine and abacavir may be coadministered without dose adjustments.

Viramune Summary of Product Characteristics, Boehringer Ingelheim Ltd, November 2019.

No Interaction Expected

Abacavir (ABC)

Nicardipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nicardipine is metabolised mainly by CYP3A4 and to a lesser extent by CYP2D6 and CYP2C8.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Niclosamide

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. After oral administration, absorption of niclosamide is considered minimal.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nicorandil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of nicorandil takes place mainly via denitration with the denitrated product then merging into the nicotinamide pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nicotinamide (Niacinamide) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with nicotinamide when given alone or in multivitamins. Nicotinamide is metabolized by nicotinamide methyltransferase to N-methylnicotinamide which is then metabolized by xanthine oxidase and aldehyde oxidase. Renal elimination of unchanged nicotinamide is minimal.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nifedipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nifedipine is metabolised mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nifurtimox

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on limited data concerning metabolism, elimination and toxicity of nifurtimox, there is little potential for interaction, although due to the lack of data, vigilance is required if administering nifurtimox with antiretrovirals. Nifurtimox appears to be biotransformed partially at a cytochrome P450 level but mostly by NADPH P450 reductase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nilotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Nilotinib is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nimesulide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nimesulide is extensively metabolized in the liver following multiple pathways including CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nisoldipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nisoldipine is metabolised mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nitrendipine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitrendipine is extensively metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nitrofurantoin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. 30-40% of a nitrofurantoin dose is eliminated unchanged via the kidneys, with a small proportion metabolized to aminofurantoin.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nitrous oxide

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Most inhaled nitrous oxide is rapidly eliminated unchanged through the lungs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norelgestromin (patch)

Quality of Evidence: Very Low

Summary:

Coadministration with transdermally delivered norelgestromin/ethinylestradiol has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norelgestromin is metabolized to norgestrel (possibly by CYP3A4). Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norethisterone [Norethindrone] (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norethisterone and mestranol or ethinylestradiol has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4. Mestranol is rapidly and almost completely converted to ethinylestradiol by CYP2C9; ethinylestradiol is mainly metabolised by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norethisterone [Norethindrone] (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with norethisterone as hormone replacement therapy (HRT) has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4. Abacavir does not interact with this metabolic pathway. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norethisterone [Norethindrone] (IM depot injection)

Quality of Evidence: Very Low

Summary:

Coadministration of a norethisterone IM depot injection has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norethisterone [Norethindrone] (POP)

Quality of Evidence: Very Low

Summary:

Coadministration of a norethisterone progestogen-only pill (POP) has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Norethisterone is metabolized by CYP3A4. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norgestimate (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norgestimate/ethinylestradiol has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestimate is deacetylated to the active metabolite norelgestromin which is then metabolised to norgestrel, possibly by CYP3A4. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norgestrel (COC)

Quality of Evidence: Very Low

Summary:

Coadministration of a combined oral contraceptive (COC) containing norgestrel/ethinylestradiol has not been studied. Norgestrel is a racemic mixture with levonorgestrel being biologically active. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Ethinylestradiol is mainly metabolized by hydroxylation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norgestrel (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with norgestrel as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestrel is a racemic mixture with levonorgestrel being biologically active. Levonorgestrel is metabolized by CYP3A4 and is glucuronidated to a minor extent. Abacavir does not interact with these metabolic pathways. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nortriptyline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as nortriptyline is metabolized mainly by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nystatin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Systemic absorption of nystatin from oral or topical dosage forms is not significant, therefore no drug interactions are expected.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ofloxacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely as ofloxacin is primarily eliminated by the kidney.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Olanzapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Olanzapine is metabolized mainly by CYP1A2, but also by glucuronidation (UGT1A4).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Olmesartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Olmesartan medoxomil is de-esterified to the active metabolite olmesartan which is eliminated in the faeces and urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Olodaterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olodaterol is metabolized by CYP2C8, CYP2C9, is glucuronidated via several UGTs, and is a substrate of P-gp. Abacavir does not interfere with olodaterol metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ombitasvir/Paritaprevir/r

Quality of Evidence: Moderate

Summary:

Coadministration with ombitasvir/paritaprevir/ritonavir has not been studied. Coadministration of ombitasvir/paritaprevir/ritonavir + dasabuvir and abacavir/lamivudine (600/300 mg once daily) was studied in 12 HIV/HCV-negative subjects and had no clinically significant effect on the pharmacokinetics of ombitasvir, paritaprevir, ritonavir, dasabuvir, abacavir or lamivudine. No dose adjustment is required for ombitasvir/paritaprevir/ritonavir or abacavir during coadministration.

Description:

Coadministration of ombitasvir/paritaprevir/ritonavir + dasabuvir and abacavir/lamivudine (600/300 mg once daily) was studied in 12 HIV/HCV-negative subjects. During coadministration abacavir exposures were up to 13% lower; lamuvidine Cmax and AUC were up to 13% lower and Ctrough was 29% higher. Exposure of ombitasvir and dasabuvir were up to 18% lower, and paritaprevir and ritonavir Ctrough both decreased by 34%. No dose adjustment is recommended for ombitasvir/paritaprevir/ritonavir + dasabuvir or abacavir/lamuvudine during coadministration.
Drug-drug interactions of ombitasvir/paritaprevir/r plus dasabuvir with dolutegravir or abacavir plus lamivudine.
Khatn A, Trinh R, Zhao W, et al. 16th International Workshop on Clinical Pharmacology of HIV and Hepatitis Therapy, Washington DC, May 2015, Abstract 57.

No Interaction Expected

Abacavir (ABC)

Ombitasvir/Paritaprevir/r + Dasabuvir

Quality of Evidence: Moderate

Summary:

Coadministration of ombitasvir/paritaprevir/ritonavir + dasabuvir and abacavir/lamivudine (600/300 mg once daily) was studied in 12 HIV/HCV-negative subjects and had no clinically significant effect on the pharmacokinetics of ombitasvir, paritaprevir, ritonavir, dasabuvir, abacavir or lamivudine. No dose adjustment is required for ombitasvir/paritaprevir/ritonavir + dasabuvir or abacavir during coadministration.

Description:

Coadministration of ombitasvir/paritaprevir/ritonavir (25/150/100 mg, once daily) and dasabuvir (250 mg, twice daily) with abacavir (300 mg once daily) and lamivudine (300 mg, once daily) was studied in 12 healthy volunteers. Abacavir Cmax and AUC decreased by 13% and 6%, respectively; abacavir Ctrough could not be determined as concentrations were below the lower limit of quantification for the majority of subjects. Lamivudine Cmax and AUC decreased by 22% and 12%, respectively, while Ctrough increased by 29%. The changes in abacavir and lamivudine pharmacokinetic parameters are not expected to influence the efficacy or safety profiles of either medication. Ombitasvir Cmax, AUC and Ctrough decreased by 18%, 9% and 8%, respectively; paritaprevir Cmax, AUC and Ctrough decreased by 16%, 18% and 27%, respectively; ritonavir Cmax, AUC and Ctrough decreased by 12%, 12% and 7%. Dasabuvir Cmax, AUC and Ctrough decreased by 6%, 9% and 5%. None of the changes in pharmacokinetic parameters for ombitasvir, paritaprevir, ritonavir or dasabuvir were considered clinically significant. The authors conclude that ombitasvir/paritaprevir/r + dasabuvir does not have any clinically relevant drug-drug interactions with abacavir and lamivudine and no dose adjustments are required.

Drug-drug interaction between the direct-acting antiviral regimen of ombitasvir-paritaprevir-ritonavir plus dasabuvir and the HIV antiretroviral agent dolutegravir or abacavir plus lamivudine. Khatri A, Trinh R, Zhao W, et al. Antimicrob Agents Chemother, 2016, 60(10): 795-816.

No Interaction Expected

Abacavir (ABC)

Omeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant drug interaction is unlikely. Omeprazole is mainly metabolized by CYP2C19 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ondansetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ondansetron is metabolized mainly by CYP1A2 and CYP3A4 and to a lesser extent by CYP2D6.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Orlistat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Orlistat should only be used with abacavir if separated by 4-5 hours. Orlistat reduces dietary fat absorption and may affect the absorption of antiretrovirals (especially if lipophilic). [Note: this interaction is not specific for abacavir, but for any medication taken with orlistat.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oseltamivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oseltamivir is converted to oseltamivir carboxylate by esterases which is then excreted in the urine by glomerular filtration and tubular secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxaliplatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxaliplatin undergoes non-enzymatic biotransformation and is eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxamniquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Oxamniquine is thought to be predominantly metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxandrolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxandrolone is mainly eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxazepam is mainly glucuronidated by UGTs 2B15, 1A9 and 2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxcarbazepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Oxcarbazepine is rapidly reduced by cytosolic arylketone reductases to its active metabolite, 10-hydroxycarbazepine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxprenolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as oxprenolol is largely metabolised by glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxybutynin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxybutynin is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxycodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxytocin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. However, As few data are available, care should be taken when administering oxytocin with antiretrovirals. Elimination of oxytocin occurs via the liver, kidney, functional mammary gland and oxytocinase. The plasma half-life is approximately five minutes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Paclitaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paclitaxel is primarily metabolized by CYP2C8 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Paliperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paliperidone is primarily eliminated renally (possibly via OCT) with minimal metabolism occurring via CYP2D6 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pantoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pantoprazole is mainly metabolized by CYP2C19 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Para-aminosalicylic acid

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Para-aminosalicylic acid is predominantly eliminated unchanged via the kidneys.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Paracetamol (Acetaminophen)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paracetamol is mainly metabolized by glucuronidation (UGT1A9 (major), UGT1A6, UGT1A1, UGT2B15), sulfation and, to a lesser extent, by oxidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Paromomycin

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Paromomycin is not metabolized, it is eliminated unchanged by renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Paroxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Paroxetine is mainly metabolized by CYP2D6 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pazopanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Pazopanib is metabolized by CYP3A4 and to a lesser extent 1A2 and 2C8.

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Peginterferon alfa-2a

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Abacavir is metabolised by alcohol dehydrogenase and UGT which are not affected by peginterferon alfa-2a. However, hepatic decompensation (some fatal) has occurred rarely in cirrhotic HIV/HCV co-infected patients receiving NRTI-containing HIV therapy and interferon alpha and ribavirin. Patients receiving interferon with ribavirin and NRTIs should be closely monitored for treatment-associated toxicities, especially hepatic decompensation and anaemia.

Description:

(See Summary)

Potential Interaction

Abacavir (ABC)

Peginterferon alfa-2b

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely. Abacavir is metabolised by alcohol dehydrogenase and UGT which are not affected by peginterferon alfa-2b. However, hepatic decompensation (some fatal) has occurred rarely in cirrhotic HIV/HCV co-infected patients receiving NRTI-containing HIV therapy and interferon alpha and ribavirin. Patients receiving interferon with ribavirin and NRTIs should be closely monitored for treatment-associated toxicities, especially hepatic decompensation and anaemia.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Penicillamine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination profiles of both drugs, there is little potential for interaction. Although metabolism of penicillamine is not fully elucidated, multiple mechanisms and sites of metabolism are thought to be involved. There is therefore low potential for clinically significant interactions with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Penicillins

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Penicillins are mainly eliminated in the urine (20% by glomerular filtration and 80% by tubular secretion via OAT).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pentamidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The exact metabolic pathway of pentamidine has not been clearly established. Data from animal studies suggest the involvement of CYPs 1A1, 2D6 and 2C19 in the oxidative metabolism of pentamidine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pentoxifylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on limited data for metabolism and clearance a clinically significant interaction is unlikely. The metabolism of pentoxifylline has not been well described but some studies indicate oxidation by CYP1A2, reduction by carbonyl reductase, and oxidation by carboxylase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Perazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perazine is demethylated by CYP3A4 and to a lesser extent by CYP2C9, and oxidated by FMO3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Periciazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of periciazine has not been well characterized but is likely to involve CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Perindopril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perindopril is hydrolysed to the active metabolite perindoprilat and is metabolized to other inactive metabolites. Elimination occurs predominantly via the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Perphenazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as perphenazine is metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pethidine (Meperidine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pethidine is metabolized mainly by CYP2B6 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Phencyclidine (PCP)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Phencyclidine is extensively metabolized to inactive metabolites by a variety of metabolic routes (mainly CYP3A4).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Phenelzine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenelzine is primarily metabolized by oxidation via monoamine oxidase and to a lesser extent by acetylation.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Phenobarbital (Phenobarbitone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Abacavir is metabolised by alcohol dehydrogenase and UGT. Phenobarbital may decrease abacavir plasma concentrations due to induction of UGTs, although to a moderate extent. No a priori dose adjustment is required.

Description:

Potent enzymatic inducers such as rifampicin, phenobarbital and phenytoin may via their action on UDP-glucuronyltransferases slightly decrease the plasma concentrations of abacavir.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

No Interaction Expected

Abacavir (ABC)

Phenprocoumon

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phenprocoumon is metabolized by CYP2C9 and CYP3A4.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Phenytoin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Abacavir is metabolised by alcohol dehydrogenase and UGT. Phenytoin may decrease abacavir concentrations due to induction of UGTs, although to a moderate extent. No a priori dose adjustment is required.

Description:

Potent enzymatic inducers such as rifampicin, phenobarbital and phenytoin may via their action on UDP-glucuronyltransferases slightly decrease the plasma concentrations of abacavir.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

No Interaction Expected

Abacavir (ABC)

Phytomenadione (Vitamin K) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with phytomenadione when given alone or in multivitamins. Metabolism of phytomenadione is thought to involve CYP4F2 and glucuronidation, but as glucuronidation is not the sole route of elimination, there is little potential for interaction with abacavir via competition for glucuronidation pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pilocarpine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination profiles of both drugs, there is little potential for interaction when pilocarpine is used either orally or as eye drops. Pilocarpine is primarily metabolized by CYP2A6 and serum esterases, there is therefore little potential for interaction with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pimozide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pimozide is metabolized mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pindolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pindolol is partly metabolized to hydroxymetabolites (possibly by CYP2D6) and partly eliminated unchanged in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pioglitazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pioglitazone is metabolized by mainly CYP2C8 and to a lesser extent by CYPs 3A4, 1A2 and 2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Piperacillin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Piperacillin is eliminated renally via glomerular filtration and active renal secretion by OAT1/3. Abacavir does not interfere with piperacillin elimination.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Piperaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Piperaquine is mainly metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pipotiazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of pipotiazine has not been well described but may involve CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Piroxicam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as piroxicam is primarily metabolized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pitavastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pitavastatin is metabolised by UGTs 1A3 and 2B7 with minimal metabolism by CYPs 2C9 and 2C8.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Poppers (Amyl nitrate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Amyl nitrate is metabolized rapidly by hydrolytic denitration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Posaconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as posaconazole is glucuronidated by UGT1A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Potassium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as potassium is eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pramipexole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pramipexole is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporter OCT2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prasugrel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prasugrel is a prodrug and is converted to its active metabolite mainly by CYP3A4 and CYP2B6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pravastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Praziquantel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Praziquantel is predominantly metabolised via CYP3A4, whereas abacavir is metabolised via alcohol dehydrogenase and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Prazosin undergoes extensive hepatic metabolism primarily by demethylation and conjugation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prednisolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prednisolone undergoes hepatic metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prednisone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prednisone is converted to the active metabolite prednisolone by 11-B-hydroxydehydrogenase. Prednisolone is then metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pregabalin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as pregabalin is cleared mainly by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Primaquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Primaquine is metabolised mainly through a non-CYP mediated mechanism and only a small fraction of the drug is believed to be metabolised through CYP450.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Primidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Primidone is metabolised by CYP3A4 to the active metabolite phenobarbital. Phenobarbital is an inducer of UGT enzymes and may decrease abacavir exposure, although to a moderate extent as abacavir is only partly metabolized by glucuronidation. No a priori dose adjustment is required.

Description:

Potent enzymatic inducers such as rifampicin, phenobarbital and phenytoin may via their action on UDP-glucuronyltransferases slightly decrease the plasma concentrations of abacavir.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Potential Weak Interaction

Abacavir (ABC)

Probenecid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. In vitro data suggest that probenecid is a non-selective inhibitor of UGT and coadministration could increase abacavir concentrations.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Procarbazine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Procarbazine is metabolized to azoprocarbazine by CYP450 (mainly CYP2B and 1A) and monoamine oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prochlorperazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prochlorperazine is metabolised by CYP2D6 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Proguanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Proguanil is partly excreted unchanged and partly metabolized to its more active metabolite cycloguanil by CYP2C19 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Promethazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Promethazine is metabolized mainly by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Propafenone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propafenone is metabolized mainly by CYP2D6 and to a lesser extent by CYP1A2 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Propofol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propofol is glucuronidated via UGT1A9, UGT1A8 and is oxidized mainly via CYP2B6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Propranolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Propranolol is metabolized by 3 routes (aromatic hydroxylation by CYP2D6, N-dealkylation followed by side chain hydroxylation via CYPs 1A2, 2C19, 2D6, and direct glucuronidation).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Propylthiouracil

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Propylthiouracil is extensively metabolised, predominantly via glucuronidation. The exact glucuronidation pathways are unknown. There are no data to suggest that propylthiouracil inhibits/induces glucuronidation, therefore there is little potential for clinically significant interaction with abacavir via modulation of glucuronidation pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Protamine sulphate

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on very limited data concerning the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. The metabolism of protamine has not been fully elucidated, however protamine complexed with heparin is thought to be partially metabolised by fibrinolysin.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Prucalopride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Prucalopride is minimally metabolised and mainly eliminated renally, partly by active secretion by renal transporters.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyrantel

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Pyrantel is metabolized by CYP2D6 in vitro, however absorption of an oral dose is minimal, and over 50% of a dose is excreted unchanged in the faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyrazinamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyrazinamide is mainly metabolized by xanthine oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyridostigmine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Pyridostigmine is predominantly eliminated unchanged via renal tubular secretion, there is therefore little potential for interaction with abacavir via modulation of or competition for metabolism pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyridoxine (Vitamin B6) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with pyridoxine when given alone or in multivitamins. Pyridoxine is absorbed from the GI tract and is converted to the active form pyridoxal phosphate. It is excreted in the urine as 4-pyridoxic acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyrimethamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Quercetin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Quetiapine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quetiapine is primarily metabolised by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Quinapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quinapril is de-esterified to the active metabolite quinaprilat which is eliminated primarily by renal excretion via OAT3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Quinidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Quinidine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Quinine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as quinine is extensively metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rabeprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rabeprazole is mainly metabolized by CYP2C19 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Raltegravir (RAL)

Quality of Evidence: Moderate

Summary:

Coadministration increased abacavir AUC and Cmax by 3% and 6%, respectively; Cmin decreased by 17%. Studies are required to relate the change in plasma abacavir exposure to the active intracellular carbovir triphosphate.

Description:

The steady-state pharmacokinetics of abacavir (600 mg once daily plus two NRTIs – excluding tenofovir ) were investigated when coadministered with raltegravir (400 mg twice daily) to 19 HIV+ subjects in a cross-over study. Abacavir AUC and Cmax increased by 3% and 6% and Cmin decreased by 17% in the presence of raltegravir. Exposure of abacavir’s active intracellular carbovir triphosphate anabolite was decreased, however, the clinical significance of this decrease is unclear.
Pharmacokinetics of abacavir and its anabolite carbovir triphosphate without and with darunavir/ritonavir or raltegravir in HIV-infected subjects. Jackson A, Moyle, G, Dickinson L, et al. Antivir Ther, 2012, 17(1): 19-24.

No Interaction Expected

Abacavir (ABC)

Ramipril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ramipril is hydrolysed to the active metabolite ramiprilat, and is metabolized to the diketopiperazine ester, diketopiperazine acid and the glucuronides of ramipril and ramiprilat.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ranitidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ranitidine is excreted via the kidney, partially by the cationic system.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ranolazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ranolazine is primarily metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rasagiline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely as rasagiline is metabolised predominantly by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Reboxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as reboxetine is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Red yeast rice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Red yeast rice contains monacolin K (a natural component with the same chemical structure as lovastatin) which is metabolised by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Repaglinide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Repaglinide is metabolized by CYP2C8 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Retinol (Vitamin A) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with retinol when given alone or in multivitamins. Vitamin A esters are hydrolysed by pancreatic enzymes to retinol, which is then absorbed and re-esterified. Some retinol is stored in the liver. Retinol not stored in the liver undergoes glucuronide conjugation and subsequent oxidation to retinal and retinoic acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ribavirin

Quality of Evidence: Low

Summary:

No pharmacokinetic interaction was observed in clinical studies. A possible intracellular interaction had been suggested as abacavir and ribavirin share the same phosphorylation pathways. However, a well-designed study to evaluate the effects of abacavir on intracellular ribavirin triphosphate and plasma ribavirin concentrations failed to show any significant effect. While some initial data suggested HIV/HCV co-infected patients receiving abacavir-containing regimens may be at risk of lower response to ribavirin therapy, this has not been confirmed in more recent studies.

Description:

Ribavirin steady state Cmin was prospectively determined in pharmacokinetic substudy on 124 HIV-HCV coinfected patients receiving ribavirin plus Peg-IFN from the ANRS CO-13 HEPAVIH cohort. Of these patients, 22% received abacavir. The overall median ribavirin Cmin was 1.6 mg/L with no statistical difference between abacavir users and non-users. There was no difference in the proportion of abacavir users versus non-users achieving RVR (respectively 59% versus 50%, p = 0.40) or EVR (72% versus 73%, p = 0.94), or in the HCV-RNA decline at week 4 or 12. The SVR rate was 45% for abacavir users and 24% for abacavir non-users, but the difference was not statistically significant (p = 0.059).
Ribavirin and abacavir drug interaction in HIV-HCV coinfected patients: fact or fiction? Solas C, Pambrun E, Winnock M et al. AIDS, 2012, 26(17):2193-2199.

To determine if use of abacavir, and other antiretrovirals were associated with reduced response to pegylated interferon plus ribavirin, a cohort study was performed among antiretroviral-treated HIV/HCV patients initiating PEG-interferon plus ribavirin (n=212). 74 patients (35%) received abacavir. No differences were observed between abacavir users and non-users in early virologic response or sustained virologic response. No association was found between other antiretrovirals and lack of early or sustained response.
The influence of abacavir and other antiretroviral agents on virologic response to hepatitis C virus therapy among antiretroviral-treated HIV-infected patients. Amorosa V, Slim J, Mounzer K et al. Antivir Ther. 2010 ; 15: 91–99.

In order to assess the influence of antiretrovirals on hepatitis C treatment with ribavirin and peginterferon, the outcomes of 493 HIV positive patients receiving first line treatment for hepatitis C were retrospectively analysed. Among the factors associated with lack of sustained virological response according to multivariate analysis, a trend was observed with abacavir use, which was significant in patients with lower ribavirin plasma levels (<2.3 µg/ml). Use of abacavir may interfere with anti-HCV efficacy of peginterferon and ribavirin treatment. As both ribavirin and abacavir are guanosine analogues, an inhibitory competition between both agents may explain this observation.
Low response to pegylated interferon plus ribavirin in HIV-infected patients with chronic hepatitis C treated with abacavir. Vispo E, Barreiro P, Pineda JA Antivir Ther. 2008;13:429-37.

In multivariate analysis of data from the French HC02-Ribavic Study, concomitant treatment with abacavir and pegIFN + ribavirin was associated with an adjusted 4.9 fold increase in the risk of non-response to anti-HCV therapy. Ribavirin can affect intracellular NRTI anabolite levels by inhibiting the enzyme IMP dehydrogenase and it is intriguing to speculate that alterations of carbovir triphosphate levels (the active metabolite of abacavir) may be at least part of the reason for the observed effect.
Early virologic failure in HIV-coinfected hepatitis C patients treated with the peginterferon-ribavirin combination: does abacavir play a role? Bani-Sadr F, et al. J Acquir Immune Defic Syndr, 2007, 45: 123-125.

No Interaction Expected

Abacavir (ABC)

Riboflavin (Vitamin B2) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with riboflavin when given alone or in multivitamins.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rifabutin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rifabutin is mainly metabolized by CYP3A4 and cholinesterase.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Rifampicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Rifampicin may decrease abacavir concentrations due to induction of UGTs, although to a moderate extent. No a priori dose adjustment is required.

Description:

Potent enzymatic inducers such as rifampicin, phenobarbital and phenytoin may via their action on UDP-glucuronyltransferases slightly decrease the plasma concentrations of abacavir.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

No Interaction Expected

Abacavir (ABC)

Rifapentine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as rifapentine is deacetylated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rifaximin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Rifaximin is mainly excreted in faeces, almost entirely as unchanged drug.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rilpivirine (RPV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. No clinically relevant drug-drug interaction is expected when rilpivirine is co-administered with abacavir.

Description:

Coadministration with abacavir has not been studied. No clinically relevant drug-drug interactions are expected. No dose adjustment is required.

Edurant Summary of Product Characteristics, Janssen-Cilag Ltd, January 2019.

No clinically relevant drug-drug interaction is expected when rilpivirine is co-administered with abacavir.

Edurant US Prescribing Information, Janssen Therapeutics, May 2019.

Potential Weak Interaction

Abacavir (ABC)

Rilpivirine/ Emtricitabine/Tenofovir alafenamide (RPV/FTC/TAF)

Quality of Evidence: Very Low

Summary:

Odefsey (rilpivirine, emtricitabine, tenofovir alafenamide) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint. Based on metabolism and clearance a clinically significant interaction with abacavir and rilpivirine, emtricitabine or tenofovir alafenamide is unlikely.

Description:

Odefsey is indicated for use as a complete regimen for the treatment of HIV-1 infection and should not be co-administered with other antiretroviral medicinal products.

Odefsey Summary of Product Characteristics, Gilead Sciences Ltd, January 2019.

Because Odefsey is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended.

Odefsey US Prescribing Information, Gilead Sciences Inc, October 2018.

No Interaction Expected

Abacavir (ABC)

Rimantadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rimantadine is both hydroxylated and glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Riociguat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Riociguat is metabolized by CYP1A1, CYP3A4, CYP2C8, CYP2J2 and is also eliminated unchanged in the bile and renally. Riociguat is a substrate of P-gp and BCRP. Abacavir does not interfere with riociguat metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Risperidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely. Risperidone is metabolized by CYP2D6 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ritonavir (RTV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely.

Description:

Abacavir has also been shown in vitro not to inhibit CYP 3A4, CYP2C9 or CYP2D6 enzymes at clinically relevant concentrations. Induction of hepatic metabolism has not been observed in clinical studies. Therefore, there is little potential for interactions with antiretroviral PIs.

Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

No Interaction Expected

Abacavir (ABC)

Rituximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rituximab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rivaroxaban

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely. Rivaroxaban is partly metabolized in the liver (by CYP3A4, CYP2J2 and hydrolytic enzymes) and partly eliminated unchanged in urine (by P-gp and BCRP).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rizatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rizatriptan is metabolized by oxidative deamination by monoamine oxidase-A (MAO-A).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rocuronium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely. Rocuronium is mostly cleared in the bile although up to 30% may be excreted renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Roflumilast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Roflumilast is metabolized by CYP3A4 and CYP1A2 to form roflumilast N-oxide, with both roflumilast and roflumilast N-oxide having PDE4 inhibitory activity. Roflumilast N-oxide is subsequently dealkylated by CYP3A4. Abacavir does not interfere with roflumilast metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ropinirole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as ropinirole is metabolised predominantly by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rosiglitazone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely. Rosiglitazone is metabolized mainly by CYP2C8 and to a lesser extent by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rosuvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as rosuvastatin is largely excreted unchanged via the faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sacubitril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sacubitril is rapidly converted to LBQ657 (active metabolite) by carboxylesterases and the active metabolite is not further metabolized to a significant extent.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Salbutamol (Albuterol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Salbutamol is metabolized to the inactive salbutamol-4’-O-sulphate.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Salmeterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Salmeterol is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Saw palmetto (Serenoa repens)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Saxagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Saxagliptin is mainly metabolized by CYP3A4/5 but does not inhibit or induce this enzyme.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Selexipag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selexipag is hydrolysed to its active metabolite by carboxylesterase 1 (CES1). Both selexipag and its active metabolite undergo oxidative metabolism by CYP2C8 and CYP3A4. The active metabolite is also glucuronidated by UGT1A3 and UGT2B7. Abacavir does not interfere with selexipag metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Senna

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Senna glycosides are hydrolysed by colonic bacteria in the intestinal tract and the active anthraquinones liberated into the colon. Excretion occurs in the urine and the faeces and also in other secretions. No clinically significant drug interactions are known.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sertraline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sertraline is mainly metabolized by CYP2B6 and to a lesser extent by CYPs 2C9, 2C19, 2D6 and 3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Seville orange juice

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sevoflurane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as sevoflurane is almost exclusively eliminated unchanged by the lungs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sildenafil (Erectile Dysfunction)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sildenafil is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sildenafil (Pulmonary Arterial Hypertension)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sildenafil is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Simeprevir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but no clinically relevant drug-drug interaction is expected. No dose adjustment is required.

Description:

Coadministration has not been studied. No clinically relevant drug drug interaction is expected. No dose adjustment is required.

Olysio Summary of Product Characteristics, Janssen-Cilag, May 2014.

No clinically relevant drug-drug interaction is expected when simeprevir is co-administered with abacavir.

Olysio US Prescribing Information, Janssen, December 2013.

No Interaction Expected

Abacavir (ABC)

Simvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Simvastatin is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sirolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sirolimus is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sitagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sitagliptin is primarily eliminated in urine as unchanged drug (active secretion by OAT3, OATP4C1, P-gp) and metabolism by CYP3A4 represents a minor elimination pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sodium nitroprusside

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Sodium nitroprusside is rapidly metabolised, likely by interaction with sulfhydryl groups in the erythrocytes and tissues. Cyanogen (cyanide radical) is produced which is converted to thiocyanate in the liver by the enzyme thiosulfate sulfurtransferase. There is little potential for sodium nitroprusside to affect the disposition of antiretrovirals, or to be affected if co-administered with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sodium stibogluconate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elimination of sodium stibogluconate is predominantly via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sofosbuvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Based on metabolism and elimination there is little potential for interaction as abacavir metabolism is mediated by UDP-glucuronyltransferases which are not affected by sofosbuvir. Sofosbuvir is a prodrug and formation of its active metabolite is unlikely to be affected by comedications.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sofosbuvir/Velpatasvir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Abacavir can be administered with velpatasvir/sofosbuvir and no dose alteration is required. Abacavir is metabolised by UGTs which are not affected by sofosbuvir/velpatasvir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sofosbuvir/Velpatasvir/Voxilaprevir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Abacavir can be administered with sofosbuvir/velpatasvir/voxilaprevir and no dose alteration is required. Abacavir is metabolised by UGTs which are not affected by sofosbuvir/velpatasvir/voxilaprevir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Solifenacin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Solifenacin is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Sorafenib is metabolized to a moderate extent by CYP3A4 and UGT1A9, UGT1A1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Spectinomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Spectinomycin is predominantly eliminated unchanged by the kidneys via glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Spironolactone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Spironolactone is partly metabolized by the flavin containing monooxygenases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Stanozolol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Stanozolol is extensively hydroxylated and conjugated followed by renal excretion. Abacavir does not affect these pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

St John's Wort

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. St John’s wort is unlikely to affect the exposure of NRTIs such as abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Streptokinase

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs there is little potential for interaction. Like other proteins, streptokinase is metabolised proteolytically in the liver and eliminated via the kidneys. Streptokinase is unlikely to affect the disposition of antiretrovirals, or to be affected if co-administered with antiretrovirals.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Streptomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Streptomycin is excreted rapidly in the urine by glomerular filtration.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Strontium ranelate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely as strontium is predominantly eliminated unchanged by the kidneys. However, food and milk can affect strontium absorption and administration should be separated by at least 2 hours. [Note: this interaction is not specific for abacavir, but for any medication taken with strontium ranelate.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sufentanil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as sufentanil undergoes extensive CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sulfadiazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies suggest that sulfadiazine is metabolized in part by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sulfadoxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sulfasalazine

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination profiles of both drugs, there is little potential for interaction. Multiple mechanisms are thought to be involved in sulfasalazine metabolism including acetylation, hydroxylation, and glucuronidation. There is therefore low potential for clinically significant interactions with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sulpiride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sulpiride is mainly excreted in the urine and faeces as unchanged drug.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sumatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sumatriptan is eliminated primarily by metabolism mediated by monoamine oxidase A.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sunitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Sunitinib is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Suramin sodium

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Suramin appears to be eliminated predominantly unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Suxamethonium (Succinylcholine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Suxamethonium is hydrolysed by plasma cholinesterase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tacrolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tacrolimus is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tadalafil (Erectile Dysfunction)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tadalafil is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tadalafil (Pulmonary Arterial Hypertension)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tadalafil is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tamoxifen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Tamoxifen metabolism occurs mostly via two pathways: the formation of N-desmethyltamoxifen (via mainly CYP3A4 and CYP3A5) is the main route (92%) and the formation of 4-hydroxytamoxifen (via CYP2D6 > 2C9/19, CYP3A4 and CYP2B6) is a minor route (7%). Further metabolism of both metabolites results in the formation of endoxifen which is thought to be the most important metabolite contributing to the pharmacologic activity of tamoxifen. Endoxifen is formed from N-desmethyltamoxifen via CYP2D6 and from 4-hydroxytamoxifen via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tamsulosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tamsulosin is metabolised mainly by CYP3A4 and to a lesser extent by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tapentadol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tapentadol is mainly glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tazobactam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Tazobactam is only minimally metabolised and is eliminated renally via glomerular filtration and active renal secretion by OAT1/3. Abacavir does not interfere with tazobactam elimination.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Telbivudine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Telbivudine is eliminated primarily by urinary excretion as unchanged drug. The renal clearance of telbivudine approaches normal glomerular filtration rate, suggesting that filtration is the main mechanism of excretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Telithromycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as telithromycin is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Telmisartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as telmisartan is mainly glucuronidated by UGT1A3.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Temazepam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as temazepam is mainly glucuronidated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Temsirolimus

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Temsirolimus is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tenofovir alafenamide (HBV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tenofovir-DF (TDF)

Quality of Evidence: Very Low

Summary:

Coadministration of tenofovir-DF (300 mg once daily) and abacavir (300 mg single dose) had no effect on tenofovir AUC or Cmax, and abacavir AUC; abacavir Cmax increased by 12%. A high rate of virological failure and emergence of resistance have been reported when lamivudine was combined with tenofovir-DF and abacavir as a once daily regimen.

Description:

Triple NRTI Therapy
There have been reports of a high rate of virological failure and of emergence of resistance at an early stage when abacavir was combined with tenofovir disoproxil fumarate and lamivudine as a once daily regimen.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, December 2018.

Triple NRTI Therapy:
There have been reports of a high rate of virological failure and of emergence of resistance at early stage when tenofovir disoproxil fumarate was combined with lamivudine and abacavir as well as with lamivudine and didanosine as a once daily regimen.
Viread Summary of Product Characteristics, Gilead Sciences Ltd, September 2016.

Coadministration of tenofovir-DF (300 mg once daily) and abacavir (300 mg single dose) was studied in 8 HIV-negative subjects. There was no change in tenofovir pharmacokinetic parameters; abacavir AUC was unaltered and Cmax increased by 12%.
Viread Prescribing Information, Gilead Sciences International Inc, February 2016.

The plasma and intracellular pharmacokinetic interaction between tenofovir and abacavir, lamivudine or lopinavir was investigated in HIV+ subjects receiving TDF + 3TC/LPV (n=7), TDF + 3TC/NVP (n=8), TDF + ABC/LPV (n=7) or TDF + ABC/NVP (n=5). Between group comparisons showed no significant interaction between tenofovir and abacavir or lamivudine.
A pharmacokinetic study in HIV infected patients under tenofovir fumarate: investigation of systemic and intracellular interaction between TDF and abacavir, or lamivudine or lopinavir/ritonavir. Pruvost A, et al. 8th International Workshop on Clinical Pharmacology of HIV Therapy, Budapest, April 2007, abstract 56.

The effect of stopping abacavir on the intracellular pharmacokinetics of tenofovir was studied in 7 HIV-infected subjects initially receiving abacavir and tenofovir with lamivudine or stavudine. Intracellular levels of tenofovir-diphosphate did not demonstrate evidence of substantial changes over time after discontinuation of abacavir. Median TDF-DP concentrations prior to and 1 month after discontinuation were 89.9 and 89.6 fmol/10^6 cells, respectively.
Intracellular pharmacokinetics of tenofovir disphosphate, carbovir triphosphate and lamivudine triphosphate in patients receiving triple-nucleoside regimens. Hawkins T, et al. J Acquir Immune Defic Syndr, 2005, 39: 406-411.

No Interaction Expected

Abacavir (ABC)

Terazosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as terazosin is extensively metabolized in the liver possibly via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Terbinafine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely. Terbinafine is metabolized by CYP1A2, 2C9, 3A4 and to a lesser extent CYP2C8 and 2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Terfenadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terfenadine undergoes extensive metabolism mainly by CYP3A4 to form azacyclonol and terfenadine alcohol.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Testosterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely as testosterone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tetracaine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Absorbed tetracaine is predominantly metabolised by pseudocholinesterases in the plasma.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tetracyclines

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tetracyclines are eliminated unchanged primarily by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Thalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as thalidomide is cleared by non-enzymatic hydrolysis.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Theophylline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Theophylline is mainly metabolized by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Thiamine (Vitamin B1) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with thiamine when given alone or in multivitamins.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Thiopental

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Although pentobarbital (a potent inducer of hepatic microsomal drug metabolism) is formed during thiopental metabolism, levels do not reach the therapeutic range.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Thioridazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Thioridazine is metabolized by CYP2D6 and to a lesser extent by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tiagabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tiagabine is metabolised by CYP3A4/5.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tiapride

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tiapride is excreted largely unchanged in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ticagrelor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ticagrelor undergoes extensive CYP3A4 metabolism and is only a mild inhibitor of CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Timolol

Quality of Evidence: Very Low

Summary:

This interaction has not been studied. Based on the metabolism/elimination profiles of both drugs, there is little potential for interaction when timolol is used either orally or as eye drops. Timolol is predominantly metabolised via CYP2D6, there is therefore little potential for interaction with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tinidazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tinidazole is partly metabolized by CYP3A4, but abacavir does not inhibit or induce CYP450 enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tiotropium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tiotropium bromide is predominantly excreted unchanged in the urine. Metabolism by CYP2D6 and CYP3A4 is only a minor role in its elimination.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tizanidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely as tizanidine is metabolised by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tolbutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tolbutamide is mainly metaboliized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tolterodine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on the metabolism/elimination and toxicity profiles of both drugs, there is little potential for interaction. Tolterodine is primarily metabolised by CYP2D6 with CYP3A4 having a major role in CYP2D6 poor metabolisers.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Topiramate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Topiramate is mainly eliminated by renal elimination in unchanged form (up to 60% of the dose) and partly by oxidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Topotecan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Topotecan undergoes both hepatic and renal elimination. Hepatic elimination involves mainly non-enzymatic hydrolysis and, to a minor extent, CYP mediated N-demethylation as well as glucuronidation. Renal elimination is by both active secretion (mainly via OAT3) and glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Torasemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as torasemide is mainly metabolized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Toremifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Toremifene is mainly metabolized by CYP3A4 to N-demethyltoremifene.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tramadol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tramadol is metabolized by CYPs 3A4, 2B6, and 2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trandolapril

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely as trandolapril is hydrolysed to trandolaprilat.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tranexamic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tranexamic acid is mainly cleared by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tranylcypromine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as tranylcypromine is hydroxylated and acetylated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trazodone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely as trazodone is primarily metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Treprostinil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Treprostinil is mainly metabolized by CYP2C8 and to a lesser extent by CYP2C9. Abacavir does not interfere with treprostinil metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Triamcinolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a pharmacokinetic interaction is unlikely as triamcinolone is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Triazolam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant drug-drug interaction is unlikely as triazolam is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Triclabendazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied, but based on metabolism and clearance a clinically significant interaction is unlikely. Triclabendazole appears to be metabolised in part by CYP450 enzymes, whereas abacavir is metabolised by alcohol dehydrogenase and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trimethoprim/Sulfamethoxazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trimethoprim and sulfamethoxazole are eliminated by the kidneys through glomerular filtration and tubular secretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trimipramine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Triptorelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triptorelin metabolism in humans is unknown but possibly involves degradation by peptidases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trospium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trospium is minimally metabolized and is mainly eliminated unchanged renally, in part by OCT2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Turmeric (Curcuma longa)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Data from pharmacokinetic studies suggest that curcuminoids (derived from turmeric extract) are unlikely to affect UGT-mediated metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ulipristal

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolic profiles of both drugs there is little potential for pharmacokinetic interaction. Ulipristal is mainly metabolized by CYP3A4 and to a lesser extent by CYP1A2 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Umeclidinium bromide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Umeclidinium bromide is mainly metabolized by CYP2D6 and is a substrate of P-gp. Abacavir does not interfere with umeclidinium bromide metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ursodeoxycholic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ursodeoxycholic acid is conjugated with glycine or taurine in the liver and secreted into bile. In vitro studies suggest that ursodeoxycholic acid is a CYP3A inducer. No effect on abacavir is expected as it does not undergo CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valaciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valaciclovir is converted to aciclovir which is eliminated renally via glomerular filtration and active renal secretion by OAT1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valerian

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valsartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely as valsartan is eliminated unchanged mostly through biliary excretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vancomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vancomycin is predominantly eliminated unchanged via renal glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vardenafil (Erectile Dysfunction)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as vardenafil is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Varenicline

Quality of Evidence: Very Low

Summary:

No interactions due to cytochrome P450 metabolism or renal secretion expected.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vecuronium

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vecuronium is partly deacetylated and partly cleared in the bile as parent compound.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Venlafaxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Venlafaxine is mainly metabolized by CYP2D6 and to a lesser extent by CYPs 3A4, 2C19 and 2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Verapamil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as verapamil is metabolised mainly by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vigabatrin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as vigabatrin is cleared mainly by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vilanterol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vilanterol is metabolized by CYP3A4 and is a substrate of P-gp. Abacavir does not interfere with vilanterol metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vildagliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as vildagliptin is inactivated via non-CYP mediated hydrolysis.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vinblastine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as vinblastine undergoes extensive metabolism and is excreted primarily by the biliary route.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vincristine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as vincristine is metabolized by CYP3A5/4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vinorelbine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vinorelbine is metabolized by CYP3A4, but abacavir does not inhibit or induce CYP450 enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tocopherol (Vitamin E) [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with vitamin E when given alone or in multivitamins.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Voriconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as voriconazole is metabolised by CYPs 2C19, 2C9 and 3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vorinostat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Vorinostat is mainly metabolised by glucuronidation (UGT2B17) and hydrolysis followed by B oxidation (non CYP-mediated).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vortioxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vortioxetine is mainly metabolized by CYP2D6 and to a lesser extent by CYP2C9 and CYP3A4/5. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Warfarin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Warfarin is a mixture of enantiomers which are metabolized by different cytochromes. R-warfarin is primarily metabolized by CYPs 1A2 and 3A4 whereas S-warfarin (more potent) is metabolized by CYP2C9.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Xipamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately 90% of xipamide is excreted in the urine, mainly as unchanged drug (50%) and glucuronides (30%).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zaleplon

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely as zaleplon is mainly metabolized by aldehyde oxidase and to a lesser extent CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zanamivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. A small amount of the orally inhaled zanamivir is systemically absorbed. Absorbed zanamivir is excreted unchanged in the urine whereas unabsorbed zanamivir is excreted in the faeces.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zidovudine (AZT, ZDV)

Quality of Evidence: Low

Summary:

Clinical studies have shown no clinically significant interactions between abacavir and zidovudine.

Description:

Clinical studies have shown that there are no clinically significant interactions between abacavir, zidovudine, and lamivudine.
Ziagen Summary of Product Characteristics, ViiV Healthcare UK Ltd, October 2011.

Fifteen HIV-infected patients were enrolled in a crossover-designed drug interaction trial evaluating single doses of abacavir (600 mg), lamivudine (150 mg), and zidovudine (300 mg) alone or in combination. Analysis showed no clinically relevant changes in the pharmacokinetics of abacavir with the addition of lamivudine or zidovudine or the combination of lamivudine and zidovudine. Lamivudine exposure (AUC decreased 15%) and zidovudine exposure (AUC increased 10%) did not show clinically relevant changes with concurrent abacavir.
Ziagen Prescribing Information, ViiV Healthcare, June 2019.

Multiple dose pharmacokinetics were determined in HIV-infected subjects following coadministration of abacavir (200, 400 or 600 mg three times daily or 300 mg twice daily) alone or with zidovudine (200 mg three times daily or 300 mg twice daily). Coadministration of zidovudine had only small and inconsistent effects on the steady state pharmacokinetics of abacavir that did not increase with dose. At the clinical abacavir dose (300 mg twice daily), zidovudine coadministration had no effect on abacavir AUC. The pharmacokinetic profiles of zidovudine in the absence of abacavir were not determined; however, mean AUC and Cmax values for zidovudine in the presence of abacavir were comparable to historical steady state values.
Multiple-dose pharmacokinetics and pharmacodynamics of abacavir alone and in combination with zidovudine in human immunodeficiency virus-infected adults. McDowell JA, et al. Antimicrob Agents Chemother, 2000, 44:2061-2067.

The pharmacokinetics and safety of single doses of abacavir (600 mg), zidovudine (300 mg) and lamivudine (150 mg) were evaluated when given alone or with either or both of the other drugs to 13 HIV-infected subjects. Coadministration of abacavir with zidovudine (with or without lamivudine) decreased ZDV Cmax by ~20%, delayed ZDV Tmax by 0.5h and increased AUC of zidovudine glucuronide by up to 40%. There were no differences in the pharmacokinetics of abacavir when given alone, or with zidovudine or lamivudine, or with both zidovudine and lamivudine.
Single dose pharmacokinetics and safety of abacavir (1592U98), zidovudine, and lamivudine administered alone and in combination in adults with human immunodeficiency virus infection. Wang LH, et al. Antimicrob Agents Chemother, 1999, 43: 1708-1715.

No Interaction Expected

Abacavir (ABC)

Ziprasidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Approximately two thirds of ziprasidone metabolic clearance is by reduction, with less than one third by CYP enzymes (mainly CYP3A4).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zoledronic acid (Zoledronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. Zoledronic acid is eliminated unchanged renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zolmitriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zolmitriptan is metabolized by CYP1A2 and the N-demethylated metabolite (active) undergoes further metabolism by MAO-A. In vitro data indicate that zolmitriptan is a substrate of P-glycoprotein. Abacavir does not affect the zolmitriptan metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zolpidem

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Zolpidem is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C9 and CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zonisamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zonisamide is metabolized partly by CYP3A4 and also by N-acetyl-transferases and conjugation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zopiclone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Zopiclone is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C8.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zotepine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zotepine is mainly metabolized by CYP3A4 and to a lesser extent CYP1A2 and CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zuclopenthixol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zuclopenthixol is metabolized by sulphoxidation, N-dealkylation (by CYP2D6 and CYP3A4) and glucuronidation.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Perampanel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Perampanel is metabolised mainly by CYP3A4/5. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Perampanel is unlikely to have a clinically relevant effect on UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rivastigmine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rivastigmine is extensively metabolised by cholinesterase-mediated hydrolysis with minimal involvement of CYP450 enzymes. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Galantamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Galantamine is metabolised mainly by CYP2D6 and CYP3A4, but is also glucuronidated and excreted in urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Opipramol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Opipramol is metabolized by CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cenobamate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cenobamate is primarily glucuronidated by UGT2B7 and to a lesser extent by UGT2B4. CYP3A4 contributes to cenobamate metabolism but to a minor extent.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sotalol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sotalol is mainly eliminated unchanged by the kidney by glomerular filtration and to a small degree by active secretion via the renal transporters OCT2 and MATE1.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Brincidofovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brincidofovir is a prodrug converted to cidofovir which is eliminated renally via glomerular filtration and active renal secretion by OAT1 and OAT3. Abacavir does not affect this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clotrimazole (pessary, troche)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clotrimazole undergoes hepatic metabolism likely via CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Venetoclax

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Venetoclax is metabolised by CYP3A4. Abacavir is metabolised by alcohol dehydrogenase and UGTs. Venetoclax does not affect UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Favipiravir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Favipiravir undergoes no CYP-mediated metabolism but is mainly metabolised by aldehyde oxidase with UGT having a minor role. Abacavir is metabolised by alcohol dehydrogenase and UGTs. Favipiravir does not affect UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tixagevimab/ Cilgavimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Tixagevimab and cilgavimab are IgG1 monoclonal antibodies and are likely to be eliminated via intracellular catabolism, similarly to endogenous IgG.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Apremilast

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Apremilast is metabolized by multiple pathways involving hydrolysis, glucuronidation and oxidation by CYP3A4. Apremilast has no inhibitory or inducing effects or drug transporters. Abacavir does not interact with apremilast’s elimination pathways. Note: severe diarrhoea, nausea and vomiting can occur within the first few weeks after initiating apremilast treatment. Patients should be instructed to contact their healthcare provider if they experience severe diarrhoea, nausea or vomiting as this could potentially alter the absorption of orally administered antiretroviral drugs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Isavuconazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isavuconazole is metabolised by CYP3A4/5 and UGTs. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabotegravir PrEP [long acting] (CAB LA, PrEP)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Note, cabotegravir used as PrEP is not expected to be coadministered with antiretrovirals except in the case of breakthrough infection when an antiretroviral treatment should be initiated. Residual concentrations of cabotegravir may remain in the systemic circulation for prolonged periods (up to 12 months or longer) but are not expected to affect the exposure of antiretroviral drugs initiated after discontinuation of Apretude.

Description:

Residual concentrations of cabotegravir may remain in the systemic circulation of individuals for prolonged periods (up to 12 months or longer). These residual concentrations are not expected to affect the exposures of antiretroviral drugs that are initiated after discontinuation of Apretude.

Apretude Prescribing Information, ViiV Healthcare, December 2021.

No Interaction Expected

Abacavir (ABC)

Yohimbine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Yohimbine is predominantly metabolized by CYP2D6 with some participation of CYP3A4. Abacavir does not interfere with yohimbine metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desvenlafaxine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desvenlafaxine is mainly metabolized by glucuronidation and to a minor extent through oxidative metabolism by CYP3A4 and CYP2C19. Renal elimination of unchanged desvenlafaxine also constitutes an important route of elimination.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Guggulsterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. In vitro studies suggest that guggulsterone activates PXR and therefore has the potential to induce CYP3A4 metabolism. No effect on abacavir is expected as it does not undergo CYP3A4 metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methylergometrine (Methylergonovine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methylergometrine is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Methylergometrine is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pizotifen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pizotifen is glucuronidated by UGT2B10. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Pizotifen is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Naratriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Naratriptan is metabolised by a wide range of CYP enzymes and is mainly excreted in urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Significant metabolic drug interactions with naratriptan are not anticipated.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Frovatriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Frovatriptan is metabolized by CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Frovatriptan is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Galcanezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Galcanezumab is a monoclonal IgG4 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fremanezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fremanuzemab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Erenumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erenumab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eptinezumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eptinezumab is a monoclonal IgG1 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Homeopathic remedies

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. There is no evidence that homeopathic remedies interact with conventional medicines, provided they are from a reputable source, and of the strength stated. However, caution may be required as some remedies termed “low potency” are less dilute, and some remedies may contain alcohol.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vedolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vedolizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Interactions with drug metabolizing enzymes or drug transporters are unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tinzaparin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tinzaparin is partially metabolised by desulfation and depolymerization, and then renally excreted. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Raloxifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Raloxifene undergoes hepatic glucuronidation (by UGT1A1 and UGT1A9) and extra-hepatic glucuronidation (by UGT1A8 and UGT1A10). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bumetanide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bumetanide is hepatically metabolized and approximately 50-80% of bumetanide is excreted in the urine by OAT1 and OAT3, mainly as unchanged drug (~50%). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flupentixol (Flupenthixol)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flupentixol is metabolised by sulfoxidation and dealkylation and is a substrate of UGT. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Flupentixol is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tofacitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tofacitinib undergoes hepatic metabolism (70%) primarily by CYP3A4 with a minor contribution from CYP2C19, and is eliminated renally (30%). Abacavir is metabolized by alcohol dehydrogenase and UGTs. Tofacitinib is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Procyclidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Little is known about procyclidine metabolism but it is likely to be metabolized by CYP450s and glucuronidated. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Abacavir is unlikely to affect procyclidine metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valproic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely. Valproic acid circulates in plasma as the valproate ion. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Orphenadrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Orphenadrine is extensively metabolized (limited information on metabolic pathway). Abacavir is metabolized by alcohol dehydrogenase and UGTs. Abacavir is unlikely to affect orphenadrine metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Minoxidil (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Minoxidil is a substrate of UGTs (the specific UGTs have not been well described). Abacavir is metabolized by alcohol dehydrogenase and UGTs. The likelihood of clinically significant interactions is low as only 1-2% of a topically applied minoxidil dose is absorbed.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sodium valproate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely. Sodium valproate circulates in plasma as the valproate ion. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Minoxidil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Minoxidil is a substrate of UGTs (the specific UGTs have not been well described). Abacavir is metabolized by alcohol dehydrogenase and UGTs. Minoxidil is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Benzatropine (Benztropine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Available information on the metabolism of benzatropine is limited but no clinically significant interactions are expected. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valproate semisodium (Divalproex sodium)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically relevant drug interaction is unlikely. Valproate semisodium (divalproex semisodium) is a stable coordination compound comprised of sodium valproate and valproic acid and dissociates to the valproate ion in the gastrointestinal tract. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabergoline (lactation suppression)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabergoline is extensively metabolized by the liver predominantly via hydrolysis (non-CYP mediated metabolism).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hydroxychloroquine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Hydroxychloroquine undergoes CYP mediated metabolism by CYPs 2C8, 3A4 and 2D6, and is also eliminated unchanged via the kidney. Due to the multiple elimination pathways, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Brimonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brimonidine is metabolized mainly by aldehyde oxidase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atomoxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atomoxetine is metabolized by CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bosutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bosutinib is metabolized by CYP3A4. Abacavir does not interact with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabergoline (Parkinson's disease)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabergoline is extensively metabolized by the liver predominantly via hydrolysis (non-CYP mediated metabolism).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabazitaxel

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabazitaxel is metabolized by CYP3A4. Abacavir does not interact with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lomitapide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lomitapide is predominantly metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Lomitapide is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabotegravir [oral] (CAB oral)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

Based on the in vitro and clinical drug interaction profile, cabotegravir is not expected to alter concentrations of other anti-retroviral medications including protease inhibitors, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, integrase inhibitors, entry inhibitors and ibalizumab.

Vocabria (cabotegravir oral and injection) European Summary of Product Characteristics, ViiV Healthcare, January 2021.

No Interaction Expected

Abacavir (ABC)

Tocopherol (Vitamin E) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Riboflavin (Vitamin B2) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Retinol (Vitamin A) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vitamin A esters are hydrolysed by pancreatic enzymes to retinol, which is then absorbed and re-esterified. Some retinol is stored in the liver. Retinol not stored in the liver undergoes glucuronide conjugation and subsequent oxidation to retinal and retinoic acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pyridoxine (Vitamin B6) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pyridoxine is absorbed from the GI tract and is converted to the active form pyridoxal phosphate. It is excreted in the urine as 4-pyridoxic acid.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Phytomenadione (Vitamin K) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of phytomenadione is thought to involve CYP4F2 and glucuronidation, but as glucuronidation is not the sole route of elimination, there is little potential for an interaction with abacavir via competition for glucuronidation pathways. Renal elimination of phytomenadione is minimal.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nicotinamide (Niacinamide) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nicotinamide is metabolized by nicotinamide methyltransferase to N-methylnicotinamide which is then metabolized by xanthine oxidase and aldehyde oxidase. Renal elimination of unchanged nicotinamide is minimal.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iodine [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Iodine is converted to iodide, which is trapped in the thyroid gland. Iodides are excreted mainly in the urine with smaller amounts excreted in the faeces, sweat and saliva.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cyanocobalamin (Vitamin B12) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cyanocobalamin undergoes enterohepatic recycling and is excreted almost entirely in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Colecalciferol (Vitamin D3) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of vitamin D to active metabolites occurs in the liver and kidneys, and is thought to involve CYP3A4 and CYP24A1. There is little potential for an interaction with abacavir via modulation of, or competition for, metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Filgrastim

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Filgrastim is eliminated mainly by neutrophil-mediated clearance and renal excretion.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Deferasirox

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Deferasirox is mainly glucuronidated by UGT1A1 and to a lesser extent by UGT1A3; CYP-mediated metabolism appears to be minor (~8%). Abacavir is metabolized by alcohol dehydrogenase and UGTs. Deferasirox is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Molnupiravir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Molnupiravir is rapidly metabolized by esterases to a nucleoside metabolite which is phosphorylated to an active triphosphate. Molnupiravir is unlikely to have significant drug-drug interactions with other therapies.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bismuth subsalicylate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bismuth subsalicylate is largely hydrolysed in the stomach to form salicylic acid, which is rapidly absorbed, and insoluble bismuth salts, which are excreted unchanged in faeces. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Bismuth subsalicylate is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Chlormadinone (COC)

Quality of Evidence: Very Low

Summary:

Coadministration with a chlormadinone-containing combined oral contraceptive (COC) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Chlormadinone undergoes extensive hepatic metabolism by hydroxylation (likely CYP mediated). Ethinylestradiol is also metabolized by hydroxylation and glucuronidation. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Macrogol (Polyethylene glycol, PEG 3350, PEG 4000)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Macrogol is unabsorbed from the gastrointestinal tract and is excreted, unaltered, in faeces. Any macrogol that does enter the circulation is excreted in urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs. However, the absorption of other oral medications may be reduced due to increased gastrointestinal transit with macrogol. Do not take macrogol within two hours of taking another oral medication. [Note: this interaction is not specific for abacavir, but for any oral medication taken with macrogol.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dupilumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dupilumab is an IgG4 monoclonal antibody and is expected to be degraded into small peptides and amino acids via catabolic pathways in the same manner as endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sotrovimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Sotrovimab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Iron supplements (infusion/injection)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Blinatumomab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolic pathway of blinatumomab has not been characterized. Like other protein therapeutics, blinatumomab is expected to be degraded into small peptides and amino acids via catabolic pathways.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Rilpivirine/ Emtricitabine/Tenofovir-DF (RPV/FTC/TDF)

Quality of Evidence: Very Low

Summary:

Eviplera/Complera (rilpivirine, emtricitabine, tenofovir-DF) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint. Based on metabolism and clearance a clinically significant interaction with abacavir and rilpivirine, emtricitabine or tenofovir-DF is unlikely. Coadministration of tenofovir-DF (300 mg once daily) and abacavir (300 mg single dose) had no effect on abacavir AUC but Cmax increased by 12%. A similar increase in abacavir Cmax may occur with rilpivirine/emtricitabine/tenofovir-DF.

Description:

Because Complera is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended.

Complera US Prescribing Information, Gilead Sciences Inc, November 2019.

The plasma and intracellular pharmacokinetic interaction between tenofovir and abacavir, lamivudine or lopinavir was investigated in HIV+ subjects receiving TDF + 3TC/LPV (n=7), TDF + 3TC/NVP (n=8), TDF + ABC/LPV (n=7) or TDF + ABC/NVP (n=5). Between group comparisons showed no significant interaction between tenofovir and abacavir or lamivudine.

A pharmacokinetic study in HIV infected patients under tenofovir fumarate: investigation of systemic and intracellular interaction between TDF and abacavir, or lamivudine or lopinavir/ritonavir. Pruvost A, et al. 8th International Workshop on Clinical Pharmacology of HIV Therapy, Budapest, April 2007, abstract 56.

The effect of stopping tenofovir on the intracellular pharmacokinetics of abacavir was studied in 8 HIV-infected subjects initially receiving abacavir and tenofovir with lamivudine or stavudine. Intracellular levels of carbovir-triphosphate did not demonstrate evidence of substantial changes over time after discontinuation of abacavir. Median CBV-TP concentrations prior to and 1 month after discontinuation were 157 and 120 fmol/10^6 cells, respectively.

Intracellular pharmacokinetics of tenofovir disphosphate, carbovir triphosphate and lamivudine triphosphate in patients receiving triple-nucleoside regimens. Hawkins T, et al. J Acquir Immune Defic Syndr, 2005, 39: 406-411.

No Interaction Expected

Abacavir (ABC)

Alogliptin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alogliptin is primarily excreted unchanged in the urine and undergoes negligible CYP-mediated metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Semaglutide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Semaglutide is metabolized by the enzyme neutral endopeptidase. Semaglutide (oral and injectable) delays gastric emptying and has the potential to impact the rate of absorption of concomitantly administered oral medicinal products. However, based on available interaction studies, a clinically relevant effect is not expected with abacavir. Note: food, beverages and oral medicinal products can interfere with the absorption of oral semaglutide. Therefore, patients must wait at least 30 minutes after taking oral semaglutide before taking any other oral medicinal product.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dronedarone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dronedarone is primarily metabolized by CYP3A4. Abacavir does not interfere with this metabolic pathway.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Apalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Apalutamide is primarily metabolized by CYP2C8 and CYP3A4 and induces UGTs. Coadministration may decrease abacavir concentrations due to induction of UGTs although to a limited extent. No a priori dose adjustment is required.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bempedoic acid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bempedoic acid is glucuronidated by UGT2B7 and also converted to an active metabolite by aldo-keto reductase.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Icosapent ethyl

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Icosapent ethyl is eliminated via beta-oxidation similar to dietary fatty acids.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tirzepatide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tirzepatide is metabolized by proteolytic cleavage. Tirzepatide delays gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. However, based on available interaction studies, a clinically relevant effect is not expected with abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Omega-3 fatty acids

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Omega-3 fatty acids are eliminated via oxidation similar to dietary fatty acids.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Omega-3 fatty acids [in multivitamins]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Omega-3 fatty acids are eliminated via oxidation similar to dietary fatty acids.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ruxolitinib (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ruxolitinib is metabolized by CYP3A4 (major) and CYP2C9 (minor). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dexamethasone (doses above 16 mg)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexamethasone is metabolized by CYP3A4. Dexamethasone and its metabolites are excreted in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ascorbic Acid (Vitamin C) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Ascorbic acid is oxidised to dehydroascorbic acid where some is metabolised to oxalic acid and the inactive ascorbate-2-sulphate. Large doses are rapidly excreted in the urine when in excess of the requirements of the body. There is therefore little potential for an interaction with abacavir via modulation of, or competition for metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Daptomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Daptomycin is eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fosfomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fosfomycin is excreted unchanged mainly via the kidney by glomerular filtration.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cabozantinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cabozantinib is metabolized by CYP3A4. Abacavir does not interact with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bicalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bicalutamide is metabolized by CYP3A4 and UGT1A9. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes. Bicalutamide inhibited UGT1A9 in vitro but no interaction is expected as abacavir is metabolized by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Darolutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Darolutamide is primarily metabolised by CYP3A4, and to a lesser extent by UGT1A9 and UGT1A1, and is a substrate of P-gp. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Flutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Flutamide is predominantly metabolised by CYP1A2 and to a lesser extent by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nilutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nilutamide is metabolised by CYP2C19. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Afatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Afatinib is mainly eliminated unchanged in the faeces. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alpelisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alpelisib is primarily metabolized by enzymatic hydrolysis to an inactive metabolite, with a minor contribution from CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Amivantamab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Amivantamab is a monoclonal IgG1 and is eliminated primarily via intracellular catabolism similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fulvestrant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of fulvestrant has not been fully evaluated: in vitro studies suggest the involvement of CYP3A4, however, non-P450 routes appear to be more predominant in vivo. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Abrocitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abrocitinib is mainly metabolized by CYP2C19 and CYP2C9, and to a lesser extent by CYP3A4 and CYP2B6. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes. Abrocitinib is not expected to have a clinically relevant effect on UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alectinib is metabolised by CYP3A4 to an active metabolite (M4), which is also metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Asciminib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Asciminib is metabolised by several pathways, including CYP3A4, UGT2B7 and UGT2B17. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atezolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atezolizumab is eliminated through catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Avapritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avapritinib is predominantly mediated by CYP3A4 and to a minor extent by CYP2C9. Abacavir is metabolized by alcohol dehydrogenase and UGTs

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Axitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Axitinib is metabolized primarily by CYP3A4 and to a lesser extent by CYP1A2, CYP2C19 and UGT1A1. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes. Axitinib does not inhibit or induce UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cemiplimab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cemiplimab is primarily metabolised through catabolic pathways and drug-drug interactions are not expected. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Risedronic acid (Risedronate)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Risedronate is not metabolized and is excreted unchanged primarily by the kidney. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Risedronate does not induce or inhibit hepatic drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Melatonin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Melatonin is metabolized mainly by CYP1A2, with CYP1A1 and CYP2C19 involved to a minor extent. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Although abacavir inhibits CYP1A1, no significant effect on melatonin is expected as CYP1A1 is a minor route of metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cyclizine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of cyclizine has not been fully described but may involve CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to inhibit or induce CYP2D6.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cinacalcet

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cinacalcet is metabolized by multiple CYP enzymes, mainly CYP3A4, CYP2D6 and CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to affect CYP3A4, CYP2D6 and CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bendamustine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bendamustine is metabolised by multiple routes including hydrolysis (main), glutathione conjugation and hepatic metabolism via CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to affect CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Binimetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Binimetinib is primarily metabolised by UGT1A1 and the active metabolite M3 is metabolised by CYP1A2 and CYP2C19. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to affect UGTs and CYPs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Brigatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brigatinib is metabolised by CYP2C8 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to affect CYP2C8 and CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Capmatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Capmatinib is primarily metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ispaghula husk

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Ispaghula husk passes predominantly unchanged through the gastrointestinal tract and there is little opportunity for marked absorption into or metabolism by the body. The mode of action of ispaghula husk is physical and does not depend on absorption into the systemic circulation. However, ispaghula husk may delay or reduce gastrointestinal absorption of other drugs and it is advisable to separate administration of ispaghula husk and orally administered drugs by 1 hour. [Note: this interaction is not specific for abacavir, but for any oral medication taken with ispaghula husk.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Psyllium husk

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Psyllium husk passes predominantly unchanged through the gastrointestinal tract and there is little opportunity for marked absorption into or metabolism by the body. The mode of action of psyllium husk is physical and does not depend on absorption into the systemic circulation. However, psyllium husk may delay or reduce gastrointestinal absorption of other drugs and it is advisable to separate administration of psyllium husk and orally administered drugs if possible. [Note: this interaction is not specific for abacavir, but for any oral medication taken with psyllium husk.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Leflunomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Leflunomide is primarily metabolized to the active metabolite teriflunomide (A771726). Metabolism is not controlled by a single enzyme and has been shown to occur in microsomal and cytosolic cellular fractions. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lurasidone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lurasidone and its active metabolite ID-14283 are primarily metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mebeverine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mebeverine is mainly metabolized by esterases. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sucralfate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sucralfate is only minimally absorbed from the gastrointestinal tract. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Sucralfate may reduce gastrointestinal absorption of other drugs and administering other orally administered drugs 2 hours before sucralfate could be considered. [Note: this interaction is not specific for abacavir, but for any oral medication taken with sucralfate.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Risankizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Risankizumab is primarily metabolised through catabolic pathways similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ceritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ceritinib is metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Calcitonin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Calcitonin is primarily metabolized via proteolysis in the kidney. Abacavir does not interfere with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cobimetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cobimetinib is metabolised by CYP3A4 and UGT2B7. Abacavir is metabolized by alcohol dehydrogenase and UGTs and is unlikely to affect CYPs and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Crizotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Crizotinib is mainly metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dabrafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dabrafenib is metabolized by CYP3A4 and CYP2C8 and the active metabolites are metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce these CYPs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dacomitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dacomitinib is metabolised by CYP2D6 (~26%) to O-desmethyl dacomitinib, an active metabolite with similar activity to dacomitinib, whilst CYP3A4 (~6%) contributes to the formation of other minor metabolites. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Daratumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Daratumumab, is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Durvalumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Durvalumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Duvelisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Duvelisib is primarily metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Vemurafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Vemurafenib is metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Infliximab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Infliximab is a TNF-alpha inhibitor and is eliminated via binding to its target antigen. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ustekinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ustekinumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Zinc

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Zinc is poorly absorbed from the gastro-intestinal tract. It is widely distributed throughout the body and is excreted in the faeces with traces appearing in the urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enasidenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enasidenib is metabolized by multiple CYP and UGTs enzymes. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Entrectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Entrectinib is predominantly metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Encorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Encorafenib is mainly metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fedratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fedratinib is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C19 and FMO3. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Erdafitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Erdafitinib is primarily metabolised by CYP2C9 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enfortumab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enfortumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism. MMAE is a substrate of CYP3A4 (and possibly CYP2D6) and P-gp. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ketoprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketoprofen is mainly metabolized by multiple UGTs. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hyoscine (Scopolamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine is metabolized by multiple pathways including CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hyoscine hydrobromide (Scopolamine hydrobromide)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine, derived from hyoscine hydrobromide, is metabolized by multiple pathways including CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Hyoscine butylbromide (Butylscopolamine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine butylbromide has poor systemic absorption and acts locally in the intestine. The main metabolic pathway is the hydrolytic cleavage of the ester bond. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etanercept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etanercept is a TNF-alpha inhibitor and is eliminated via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fostamatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fostamatinib is metabolised in the gut by alkaline phosphatase to the major active metabolite, R406, which is then metabolised by CYP3A4 and UGT1A9. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Gilteritinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Gilteritinib is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glasdegib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glasdegib is mainly metabolized by CYP3A4 and to a lesser extent by CYP2C8 and UGT1A9. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Glasdegib is unlikely to have a clinically significant effect on UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ibrutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibrutinib is metabolised primarily by CYP3A4 and to a minor extent by CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Idelalisib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Idelalisib is metabolised primarily by aldehyde oxidase, and to a lesser extent by CYP3A4 and UGT1A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Infigratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Infigratinib is mainly metabolized by CYP3A4 and to a lesser extent by FMO3. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ipilimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ipilimumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Abatacept

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abatacept is a fusion protein consisting of the extracellular domain of human CTLA-4 linked to a modified Fc portion of human IgG1 and is likely to be eliminated via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Belimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Belimumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Certolizumab pegol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Certolizumab pegol is an antibody Fab’ fragment conjugated with polyethylene glycol (PEG). The Fab’ fragment is expected to be degraded to peptides and amino acids by proteolysis; the PEG moiety is mainly excreted in urine without further metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Golimumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Golimumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ixekizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ixekizumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Cabotegravir/rilpivirine [long acting] (CAB/RPV LA)

Quality of Evidence: Very Low

Summary:

Cabenuva (cabotegravir LA, rilpivirine LA) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with abacavir would be possible from a pharmacokinetic standpoint. Residual concentrations of cabotegravir and rilpivirine may remain in the systemic circulation of patients for a prolonged period after discontinuation of intramuscular cabotegravir/rilpivirine but are not expected to affect exposure of antiretroviral drugs.

Description:

Vocabria and rilpivirine injections are intended for use as a complete regimen for the treatment of HIV-1 infection and should not be administered with other antiretroviral medicinal products for the treatment of HIV. Based on the in vitro and clinical drug interaction profile, cabotegravir is not expected to alter concentrations of other antiretroviral medications including protease inhibitors, nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, integrase inhibitors, entry inhibitors or ibalizumab.

Vocabria (cabotegravir oral and injection) European Summary of Product Characteristics, ViiV Healthcare, January 2021.

Rekambys should not be administered with other antiretroviral medicinal products, except for cabotegravir injection for the treatment of HIV-1 infection. From a drug interaction perspective, there are no limitations on the use of other antiretroviral medicinal products after discontinuing Rekambys.

Rekambys (rilpivirine prolonged release injection) European Summary of Product Characteristics, Janssen-Cilag, January 2021.

Because Cabenuva is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended. Residual concentrations of cabotegravir and rilpivirine may remain in the systemic circulation of patients for prolonged periods (up to 12 months or longer). These residual concentrations are not expected to affect the exposures of antiretroviral drugs that are initiated after discontinuation of Cabenuva.

Cabenuva (cabotegravir/rilpivirine extended release injection) US Prescribing Information, ViiV Healthcare, January 2021.

No Interaction Expected

Abacavir (ABC)

Sarilumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sarilumab is an IL-6 receptor monoclonal antibody and likely undergoes elimination via binding to its target antigen. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Secukinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Secukinumab is an IgG1 monoclonal antibody and is likely to be eliminated via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Avelumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avelumab is primarily metabolized through catabolic pathways and drug-drug interactions are not expected.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Ivosidenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Ivosidenib is primarily metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Ivosidenib has the potential to induce UGTs and may decrease abacavir concentrations, although to a limited extent. No a priori dose adjustment is required.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Larotrectinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Larotrectinib is mainly metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Larotrectinib is a weak inducer of UGTs in vitro but is unlikely to have a clinically significant effect on abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lorlatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lorlatinib is primarily metabolised by CYP3A4 and UGT1A4 and, to a lesser extent, by CYP2C8, CYP2C19, CYP3A5 and UGT1A3. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4. Lorlatinib is a weak inducer of UGTs but no dose adjustment is required for medicinal products that are mainly metabolised by UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lomustine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lomustine is extensively metabolised by CYPs, with animal studies suggesting involvement of CYP2C19, CYP2D6 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Midostaurin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midostaurin is metabolised mainly by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mitotane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mitotane is primarily metabolized in adrenal cells. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mobocertinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mobocertinib is mainly metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Carfilzomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Carfilzomib is rapidly metabolized, mainly by peptidase cleavage and epoxide hydrolysis with CYP-mediated metabolism representing a minor pathway. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Abiraterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abiraterone is metabolized by CYP3A4 and SULT2A1. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Glucose monohydrate (IV)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Glucose is rapidly absorbed into cells and metabolized into carbon dioxide and water with the release of energy. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nintedanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nintedanib is primarily metabolised by esterases to the active metabolite BIBF 1202, with CYP3A4 contributing to a minor extent. BIBF 1202 is subsequently glucuronidated by UGTs 1A1, 1A7, 1A8 and 1A10. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Green tea extracts (Camellia sinensis)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desloratadine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desloratadine is metabolized to the active metabolite 3-hydroxydesloratadine, which is subsequently glucuronidated. The enzyme(s) responsible for the formation of the active metabolite have not been identified, but no clinically relevant interactions have been observed with inhibitors of CYP enzymes. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alemtuzumab (Cancer therapy)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alemtuzumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Note, use of alemtuzumab (marketed as Lemtrada) for the treatment of relapsing remitting multiple sclerosis is contraindicated in patients with HIV infection as it causes prolonged reductions of CD4+ lymphocyte counts.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Necitumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Necitumumab is an IgG1 monoclonal antibody and is eliminated via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nivolumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nivolumab is a monoclonal IgG4 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Neratinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Neratinib is metabolised mainly by CYP3A4 and to a lesser extent by flavin-containing monooxygenase (FMO). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Olaparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olaparib is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Osimertinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Osimertinib is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Palbociclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Palbociclib is metabolised by CYP3A and SULT2A1. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Panobinostat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Panobinostat is metabolized by non-CYP and CYP mediated routes; approximately 40% of panobinostat is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pemetrexed

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pemetrexed is not appreciably metabolised and is primarily eliminated unchanged renally (70-90% recovered in 24 hours). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pomalidomide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pomalidomide is metabolised by CYP1A2 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ponatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ponatinib is metabolized mainly by CYP3A4 and to a lesser extent by CYP2C8, CYP2D6 and CYP3A5. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Regorafenib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Regorafenib is metabolized by CYP3A4 and UGT1A9. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes. Regorafenib and its metabolites inhibit UGT1A1 and UGT1A9 but no interaction is expected as abacavir is metabolized by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ribociclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ribociclib is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rucaparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rucaparib is primarily metabolised by CYP2D6 and to a lesser extent by CYP1A2 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Rucaparib is a weak inhibitor of UGT1A1 but no interaction is expected as abacavir is metabolized by UGT2B7.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Selpercatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Selpercatinib is metabolized predominantly by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Sotorasib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Sotorasib is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Talazoparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Talazoparib undergoes minimal hepatic metabolism and is primarily excreted renally via P-gp and BCRP. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trametinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trametinib is mainly metabolised by deacetylation; metabolism by CYP3A4 is considered to be a minor pathway. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Eribulin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eribulin is primarily eliminated via biliary excretion and is minimally metabolized (metabolism by CYP3A4 is negligible). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ixazomib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ixazomib is extensively metabolised by multiple CYP and non-CYP enzymes. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lenvatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenvatinib is extensively metabolised by multiple enzymes, mainly CYP3A4 and aldehyde oxidase. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Niraparib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Niraparib is metabolized by carboxylesterases and UGTs. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes. Niraparib is unlikely to have a clinically relevant effect on UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tivozanib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tivozanib is metabolised mainly by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trifluridine/Tipiracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trifluridine is mainly metabolised by thymidine phosphorylase (TPase) to form the inactive metabolite 5-(trifluoromethyl) uracil (FTY); tipiracil is not metabolised. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Tegafur/ Gimeracil/ Oteracil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Tegafur is metabolised to the active compound 5-fluorouracil by CYP2A6; gimeracil and oteracil are not metabolised by CYPs. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Fluorouracil is metabolised via the same mechanisms as endogenous uracil, including via dihydropyrimidine dehydrogenase. Nucleoside analogues such as abacavir may compete for this metabolic pathway. The clinical relevance of this interaction is unknown.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Elotuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Elotuzumab is a monoclonal IgG antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Inotuzumab ozogamicin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Inotuzumab ozogamicin is a humanized monoclonal antibody; elimination occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Obinutuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Obinutuzumab is a monoclonal IgG antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ofatumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ofatumumab is a fully human monoclonal IgG1 antibody; elimination occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Olaratumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Olaratumab is a monoclonal IgG1 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Panitumumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Panitumumab is a monoclonal IgG2 antibody; elimination is similar to endogenous IgG and occurs primarily via intracellular catabolism throughout the body. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pembrolizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pembrolizumab is an IgG4-kappa monoclonal antibody and is likely to be eliminated via intracellular catabolism, similarly to endogenous IgG. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pertuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pertuzumab is an IgG1 monoclonal antibody and is eliminated via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ginseng (Panax ginseng, Panax quinquefolis)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ayahuasca

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Polatuzumab vedotin

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Polatuzumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism and does not interact with abacavir. MMAE is a substrate of CYP3A4 and P-gp but abacavir does not interfere with these pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ashwagandha (Withania somnifera)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Donepezil

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Donepezil is metabolized by CYP3A4 and to a lesser extent by CYP2D6. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Memantine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Memantine is eliminated by active renal secretion via OCT2 and MATE1. Abacavir does not interfere with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bazedoxifene

Quality of Evidence: Very Low

Summary:

Coadministration with bazedoxifene alone or coformulated with conjugated estrogens as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bazedoxifene is glucuronidated by UGT1A1/8/10 and conjugated estrogens are metabolized by CYP3A4, CYP1A2 and are glucuronidated. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tibolone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with tibolone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tibolone is metabolized by several enzymatic pathways with no major involvement of CYP450. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Conjugated estrogens

Quality of Evidence: Very Low

Summary:

Coadministration with conjugated estrogens as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Conjugated estrogens are metabolized by CYP3A4, CYP1A2 and are glucuronidated. Abacavir does not interact with these metabolic pathways. In addition, no interaction is expected with progestogens administered as part of HRT. Note, use of conjugated estrogens as part of gender affirming treatment should be avoided as they are associated with high thromboembolic risk.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Medroxyprogesterone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on the metabolism and clearance a clinically significant interaction is unlikely. Medroxyprogesterone is metabolized by CYP3A4. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enfuvirtide (ENF, T20)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Enfuvirtide undergoes catabolism to its constituent amino acids. This metabolic pathway is unlikely to be affected by coadministered drugs. The potential for metabolic interactions with enfuvirtide is low.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Maribavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Maribavir is primarily eliminated by CYP3A4 (at least 35%), with secondary contribution from CYP1A2 (no more than 25%), and some contribution from multiple UGTs (low). Abacavir is metabolised by alcohol dehydrogenase and UGTs. Maribavir is unlikely to have a clinically significant effect on UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Terbutaline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terbutaline is eliminated primarily as sulfate and glucuronide conjugates with oral dosing and excreted mainly unchanged with inhalation dosing.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Silodosin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Silodosin is metabolized by CYP3A4, UGT2B7, as well as alcohol and aldehyde dehydrogenase. Abacavir does not interfere with these pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Letermovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and glucuronidation. Letermovir is partly eliminated by glucuronidation via UGT1A1/3, but is largely eliminated unchanged in the bile.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ketorolac

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ketorolac is partly eliminated renally and via hepatic metabolism by CYP2C8, CYP2C9 and UGT2B7. Abacavir does not interfere with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dapivirine (DPV, PrEP)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Dapivirine is metabolized mainly by CYP3A4 and to a lesser extent by glucuronidation. However, the risk of drug-drug interactions is low with the dapivirine vaginal ring due to its low systemic exposure. Furthermore, dapivirine concentrations in vaginal fluid exceed the in vitro HIV IC99 by 1000-fold.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fampridine (Dalfampridine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fampridine is metabolized by CYP2E1 but is predominantly eliminated unchanged by the kidney with active secretion by OCT2. Abacavir does not interfere with fampridine elimination pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tisotumab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tisotumab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism and does not interact with abacavir. MMAE is a substrate of CYP3A4 and P-gp but abacavir does not interfere with these pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Psilocybin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Psilocybin is rapidly dephosphorylated to psilocin which is responsible for the hallucinogenic effects. Psilocin is deactivated to multiple metabolites by alcohol dehydrogenase and monoamine oxidase or glucuronidated to psilocin-O-glucuronide by UGT1A9 in the liver or UGT1A10 in the small intestine before excretion in the urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Teicoplanin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Teicoplanin is primarily excreted via urine as unchanged drug. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Acalabrutinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Acalabrutinib is metabolized by CYP3A4. Abacavir does not interact with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Safinamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Safinamide is metabolised by high-capacity amidases which are yet to be fully characterised, CYP enzymes are unlikely to be involved. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Safinamide is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Moclobemide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moclobemide is metabolised via multiple pathways, including in part by CYP2C19 and CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Moclobemide is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nitazenes

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Netzines are a family of synthetic opioids with a potency several hundred times stronger than morphine. Little is known about nitazene metabolism but it is likely to involve CYP metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Abemaciclib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abemaciclib is metabolized by CYP3A4. Abacavir does not interact with this pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trastuzumab emtansine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trastuzumab emtansine is a monoclonal antibody-drug conjugate. Trastuzumab does not undergo CYP mediated metabolism, whereas DM1 (an active component of emtansine) is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Phentermine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Phentermine is not extensively metabolised with 70-80% of an oral dose eliminated primarily unchanged in urine. In vitro studies indicate that CYP3A4 is the primary enzyme responsible for the limited metabolism of phentermine. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tenapanor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tenapanor is minimally absorbed following oral administration and is eliminated mainly unchanged in the faeces. Limited metabolism to M1, an inactive metabolite, occurs by primarily by CYP3A4/5. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tepotinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tepotinib is metabolized by CYP3A4 and CYP2C8. No single metabolic pathway accounted for more than 25% of tepotinib elimination. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Tepotinib is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cefuroxime

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cefuroxime is not metabolised and is excreted predominantly by renal glomerular filtration, with no significant active renal tubular secretion. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cariprazine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of cariprazine and its major active metabolites is mediated mainly by CYP3A4 with a minor contribution from CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Riluzole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Riluzole is mainly metabolized by CYP1A2 and the major active metabolite is then glucuronidated. Abacavir is metabolized by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mitomycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Mitomycin is hepatically metabolised but the enzymes involved are unclear; modulation of CYP450 is unlikely to be significant. Abacavir is metabolised by alcohol dehydrogenase and UGTs. Mitomycin is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Minocycline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Minocycline is almost completely absorbed with one third excreted as unchanged drug. Unlike other tetracyclines, there is evidence that partial metabolism by CYPs (including CYP3A4) occurs. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Minocycline is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dexketoprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexketoprofen is mainly excreted as glucuronide conjugates; CYP2C8/9 plays a minor role in metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Dexketoprofen is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bromocriptine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bromocriptine is metabolised by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Bulevirtide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Bulevirtide is catabolized by peptidases and elimination occurs through binding to NTCP (a bile salt liver transporter serving as HDV/HBV entry receptor). Abacavir does not interfere with this elimination pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Febuxostat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Febuxostat is extensively metabolized by multiple UGT enzymes (UGTs 1A1, 1A3, 1A8, 1A9 and 2B7) and CYP enzymes (CYPs 1A1, 1A2, 2C8 and 2C9). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Atogepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atogepant is metabolized primarily by CYP3A4 and is a substrate of OATP. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nefopam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nefopam undergoes extensive hepatic metabolism and both unchanged nefopam and metabolites are excreted principally in the urine. Limited data suggest that CYP and UGT enzymes may have a role in the metabolism of nefopam. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Brexpiprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brexpiprazole is predominantly metabolised by CYP3A4 and CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trenbolone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trenbolone is mainly excreted in urine as glucuronide conjugates. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Trenbolone is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oxymetholone

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxymetholone undergoes oxidation, reduction and hydroxylation; CYP enzymes are unlikely to be involved. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Oxymetholone is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Collagen hydrolysate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Collagen hydrolysate is digested and absorbed as essential amino acids for use in essential physiological processes. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Collagen hydrolysate is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Mucuna pruriens

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on very limited data for metabolism and clearance, a clinically significant interaction is unlikely. No pharmacokinetic interactions have been reported with Mucuna pruriens.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enteral Feeds

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Enteral feeds contain polyvalent cations. This is unlikely to affect absorption of abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Oral nutritional supplements

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Oral nutritional supplements contain polyvalent cations. This is unlikely to affect absorption of abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cedazuridine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cedazuridine is eliminated renally and converted to its epimer (which is then renally excreted). Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Decitabine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The primary route of decitabine metabolism is likely by cytidine deaminase. Decitabine is a prodrug and is activated intracellularly through sequential phosphorylation via phosphokinases activities to the active triphosphate. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Azacitidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azacitidine undergoes spontaneous hydrolysis and deamination mediated by cytidine deaminase. Urinary excretion is the primary route of elimination of azacitidine and/or its metabolites. Following cellular uptake, azacitidine is sequentially phosphorylated via phosphokinases activities to azacitidine triphosphate which is able to incorporate into DNA and RNA. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Norgestimate (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with norgestimate as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Norgestimate is deacetylated to the active metabolite norelgestromin which is then metabolised to norgestrel, possibly by CYP3A4. Abacavir does not interact with these metabolic pathways. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Progesterone (HRT)

Quality of Evidence: Very Low

Summary:

Coadministration with progesterone as hormone replacement therapy (HRT) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Progesterone is metabolized by CYP3A4. Abacavir does not interact with these metabolic pathways. In addition, no interaction is expected with estradiol or estrogens administered as part of HRT.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Drospirenone (POP)

Quality of Evidence: Very Low

Summary:

Coadministration with a drospirenone progestogen-only pill (POP) has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drospirenone is metabolized to a minor extent via CYP3A4. Abacavir does not interact with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Brentuximab vedotin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Brentuximab vedotin is an antibody-drug conjugate comprising a monoclonal antibody and monomethyl auristatin E (MMAE), a potent chemotherapeutic agent. The monoclonal antibody undergoes elimination via intracellular catabolism and does not interact with abacavir. MMAE is a substrate of CYP3A4 and P-gp but abacavir does not interfere with these pathways.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Colestyramine (cholestyramine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Colestyramine may delay or reduce the absorption of drugs. Administration of other drugs should be at least 1 hour before or 4-6 hours after colestyramine. [Note: this interaction is not specific for abacavir, but for any medication taken with colestyramine.]

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nirmatrelvir/ritonavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Whey Protein

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Whey protein is rapidly digested and absorbed as essential amino acids for use in physiological processes. Excess whey protein can be excreted in the urine by the kidneys. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Whey protein is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Enobosarm (Ostarine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Enobosarm is primarily excreted in faeces as unchanged drug, with CYP3A4, UGT1A1 and UGT2B7 having a minor role in enobosarm metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Enobosarm is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ecdysterone (20-hydroxyecdysone, 20E)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ecdysterone has poor bioavailability and is predominantly metabolised once it reaches the gut microbiota. Unchanged ecdysterone and ecdysterone metabolites are excreted in both urine and faeces. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Ecdysterone is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Midazolam (buccal)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midazolam is metabolized by CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ruxolitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ruxolitinib is metabolized by CYP3A4 (major) and CYP2C9 (minor). Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nitazoxanide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nitazoxanide is rapidly hydrolyzed to an active metabolite, tizoxanide, which is subsequently glucuronidated. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Canakinumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Canakinumab is an IL-1 beta monoclonal antibody and is eliminated via intracellular catabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Baricitinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Baricitinib is mainly eliminated renally through glomerular filtration and active secretion via OAT3, P-gp, BCRP and MATE2-K, with CYP3A4 metabolism representing less than 10% of its overall metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Baricitinib is not expected to have a clinically relevant effect on drugs metabolised by UGT enzymes

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Creatine monohydrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Creatine monohydrate is not degraded during normal digestion and nearly 99% of orally ingested creatine monohydrate is either taken up by muscle or excreted in urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Creatine is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Caffeine (anhydrous powder)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Caffeine is mainly metabolised by CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Caffeine is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Beta-alanine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Beta-alanine is a non-essential amino acid and dietary supplements enter the same physiological processes as endogenous beta-alanine. Excess beta-alanine is excreted in the urine by the kidneys. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Beta-alanine is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Anakinra

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Anakinra is an IL-1 receptor antagonist which is predominantly cleared renally by glomerular filtration and subsequent tubular metabolism. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Branched chain amino acids (BCAAs; leucine, isoleucine, valine)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Branched chain amino acids (BCAAs) mainly undergo intracellular catabolism in skeletal muscle. Excess BCAAs and BCAA-derived metabolic products are excreted in the urine by the kidneys. Abacavir is metabolized by alcohol dehydrogenase and UGTs. BCAAs are unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lisdexamfetamine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lisdexamfetamine is a prodrug of dexamfetamine and is not metabolized by CYP enzymes. Dexamfetamine is metabolized by CYP2D6 to some extent, whereas a large part is excreted unchanged. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Netupitant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Netupitant is metabolized primarily by CYP3A4 and to a lesser extent by CYP2C9 and CYP2D6. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Palonosetron

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Palonosetron is mainly metabolised by CYP2D6, with minor contributions from CYP3A4 and CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pralsetinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pralsetinib is metabolized by CYP3A4 and UGT1A4 and to a lesser extent by CYP2D6 and CYP1A2. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pexidartinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pexidartinib is metabolized by CYP3A4 and UGT1A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs and does not inhibit or induce CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pemigatinib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pemigatinib is mainly metabolized by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pancreatic enzymes (pancrelipase, pancreatin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely with pancreatic enzyme preparations containing amylases, lipases and proteases.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lymecycline

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lymecycline is not metabolised and is excreted unchanged by renal and biliary routes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ferrous sulfate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dexlansoprazole

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexlansoprazole is mainly metabolized by CYP2C19 (major) and CYP3A4 (minor).

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methocarbamol

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Methocarbamol is metabolized in the liver by dealkylation, hydroxylation, and glucuronidation. Methocarbamol is unlikely to be a substrate or inhibitor of CYP enzymes. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ubrogepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ubrogepant is metabolized mainly by CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Rimegepant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Rimegepant is primarily metabolized by CYP3A4 and to a lesser extent by CYP2C9 and is a substrate of P-gp and BCRP. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Trastuzumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Trastuzumab is a monoclonal IgG antibody. Elimination is similar to endogenous IgG and occurs primarily via proteolytic catabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Octreotide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Octreotide has been reported to be metabolized in the liver but the metabolic pathway is unclear.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Emtricitabine/Tenofovir alafenamide for PrEP (FTC/TAF, PrEP)

Quality of Evidence: Very Low

Summary:

Emtricitabine and tenofovir alafenamide used as PrEP are not expected to be coadministered with antiretrovirals. Coadministration has not been studied but based on metabolism and clearance a clinically significant pharmacokinetic interaction is unlikely. A high rate of virological failure and emergence of resistance have been reported with once daily regimens of abacavir with lamivudine and tenofovir-DF; the same problems may be seen if Descovy is administered with a third nucleoside analogue.

Description:

There have been reports of a high rate of virological failure and of emergence of resistance at an early stage when tenofovir disoproxil fumarate was combined with lamivudine and abacavir as well as with lamivudine and didanosine as a once daily regimen. Therefore, the same problems may be seen if Descovy is administered with a third nucleoside analogue.

Descovy Summary of Product Characteristics, Gilead Sciences Ltd, April 2022.

No Interaction Expected

Abacavir (ABC)

Dexamethasone (low dose; 16 mg or less)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dexamethasone is metabolized by CYP3A4. Dexamethasone and its metabolites are excreted in the urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tecovirimat

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tecovirimat is metabolized by hydrolysis (major) and glucuronidation by UGT1A1 and UGT1A4. Abacavir does not interact with these metabolic pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Lenacapavir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Lenacapavir is mainly cleared as unchanged drug.

Description:

If Sunlenca is discontinued, residual concentrations of lenacapavir may remain in the systemic circulation of patients for prolonged periods. These concentrations are not expected to affect the exposures of other antiretroviral agents that are initiated after discontinuation of Sunlenca.

Sunlenca Summary of Product Characteristics, Gilead Sciences Ltd, August 2022.

No Interaction Expected

Abacavir (ABC)

Fostemsavir (FTR)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fostemsavir is a prodrug and is hydrolysed to the active compound temsavir in the small intestine. Temsavir is mainly metabolized by esterase-mediated hydrolysis with a small contribution of CYP3A4. Abacavir does not interfere with fostemsavir metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Moxonidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Moxonidine is only minimally metabolized and is eliminated renally by glomerular filtration and active secretion, mainly as unchanged moxonidine. No interaction is expected as abacavir is only partly eliminated renally.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nicotine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nicotine is metabolised mainly by CYP2A6 which is not affected by abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tolvaptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tolvaptan is extensively metabolized in the liver almost exclusively by CYP3A. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Larotrectinib is a weak inducer of UGTs in vitro but is unlikely to have a clinically significant effect on abacavir.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Methotrexate (Immunosuppressant)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance there is little potential for an interaction. Methotrexate is predominantly eliminated unchanged via the kidneys, with minimal metabolism. Results of a clinical study evaluating the co-administration of high-dose of intravenous methotrexate for chemotherapy and NRTIs (abacavir/lamivudine or emtricitabine/tenofovir-DF) showed that methotrexate half-life was not prolonged. Note, some methotrexate product labels contraindicate its use or advise caution in immunodeficiency and some contraindicate its use in HIV infection.

Description:

Methotrexate concentrations were determined in 43 HIV+ patients treated with ARVs and chemotherapy containing high dose methotrexate (3g/m2). Methotrexate elimination half-life was not affected by use of NNRTIs, integrase inhibitors or NRTIs (tenofovir /emtricitabine or abacavir/lamivudine).

The pharmacokinetics of high dose methotrexate in people living with HIV on antiretroviral therapy. Dalla Pria A, Bendle M, Ramaswami R, et al. Cancer Chemother Pharmacol, 2016, 77:653-657.

No Interaction Expected

Abacavir (ABC)

Eletriptan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Eletriptan is metabolised by CYP3A4 and does not induce or inhibit CYPs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Avatrombopag

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Avatrombopag is mainly metabolized by CYP2C9 and CYP3A4. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Pretomanid

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Pretomanid is metabolized in the liver via multiple reductive and oxidative pathways with CYP3A4 mediated metabolism representing 20% of its metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Terlipressin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Terlipressin is metabolized by various peptidases in the liver and kidney.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tesamorelin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tesamorelin is a peptide analogue which is likely eliminated by catabolism to its constituent amino acids.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Nizatidine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Nizatidine is primarily eliminated via tubular secretion and glomerular filtration in urine.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Etoricoxib

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Etoricoxib is metabolised by CYPs 3A4 (main), 2D6, 2C9, 1A2 and 2C19. Abacavir is metabolized by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Alirocumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Alirocumab is a monoclonal antibody eliminated through binding to PCSK9 at low concentrations and through a proteolytic pathway at higher concentrations.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Triamterene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Triamterene is mainly metabolized by CYP1A2. Abacavir does not interfere with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Meloxicam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Meloxicam is metabolised mainly by CYP2C9, with a minor contribution from CYP3A4.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Clotrimazole (topical)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but a clinically significant interaction is unlikely with the topical use of clotrimazole as it is minimally absorbed

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Azilsartan

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Azilsartan is mainly metabolized by CYP2C9. Abacavir does not interfere with this metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dapoxetine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapoxetine is metabolized by CYP2D6, CYP3A4 and flavin monooxygenase 1. Abacavir does not interfere with dapoxetine metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Drotaverine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Drotaverine is metabolised in the liver by O-deethylation. Clinically relevant pharmacokinetic interactions have not been reported. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Dimethyl fumarate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dimethyl fumarate is metabolized by esterases before entering the blood stream. Further metabolism occurs though the TCA cycle. Abacavir is metabolised by alcohol dehydrogenase and UGTs. Dimethyl fumarate is unlikely to have a clinically significant effect on substrates of CYPs, UGTs and P-gp.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Colesevelam

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Colesevelam is not absorbed from the gastrointestinal tract, is not metabolised and does not affect CYP enzymes. Abacavir is metabolised by alcohol dehydrogenase and UGTs. However, given that colesevelam can reduce the gastrointestinal absorption of some drugs, colesevelam should be administered at least four hours before or after abacavir to minimize the risk of reduced absorption.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Cytisine (Cytisinicline)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Cytisine is primarily excreted renally as unchanged drug. There are no reports of CYP or transporter involvement and significant pharmacokinetic interactions are unlikely. Abacavir is metabolised by alcohol dehydrogenase and UGTs.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Coenzyme Q10 (Ubidecarenone)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The major route of elimination for coenzyme Q10 is by biliary and faecal excretion; only a small fraction is eliminated in the urine. Abacavir is metabolised by alcohol dehydrogenase and UGTs. Coenzyme Q10 is unlikely to have a clinically significant effect on substrates of CYP3A4, UGTs and P-gp.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Thiamine (Vitamin B1) [alone]

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Valganciclovir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Valganciclovir is rapidly hydrolysed to ganciclovir. Ganciclovir is primarily eliminated by the kidney and in vitro data suggest that it is a substrate of the renal transporter OAT1. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Valganciclovir and ganciclovir are unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Isosorbide mononitrate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isosorbide mononitrate is completely absorbed and is not subject to first pass metabolism by the liver. It is denitrated and glucuronidated to inactive metabolites before being excreted mainly in the urine. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Only ~25% of an isosorbide mononitrate dose is glucuronidated, there is therefore little potential for clinically significant interactions with abacavir via competition for glucuronidation pathways.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Indometacin (Indomethacin)

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Indometacin is metabolized predominantly by acylation followed by glucuronidation (mainly UGT2B7 and partly by UGT1A9). Abacavir is metabolized by alcohol dehydrogenase and UGTs. Indometacin is unlikely to affect abacavir metabolism.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Desmopressin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Desmopressin undergoes no significant hepatic metabolism and is not a substrate for CYP enzymes. Abacavir is metabolized by alcohol dehydrogenase and UGTs. No metabolic drug interactions are expected with desmopressin.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Midodrine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Midodrine is a prodrug converted to its active metabolite desglymidodrine in various tissues. Desglymidodrine is mainly metabolized by CYP2D6 and to a lesser extent by CYP1A2.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ferrous fumarate

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely.

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Sevelamer

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Sevelamer is a resin not absorbed from the GI tract that may affect the bioavailability of other medicinal products. In the absence of data, when administering any medicinal product where a reduction in the bioavailability could have a clinically significant effect on safety or efficacy, the medicinal product should be administered at least one hour before or three hours after sevelamer. [Note: this interaction is not specific for abacavir, but for any medication taken with sevelamer].

Description:

(See Summary)

Potential Weak Interaction

Abacavir (ABC)

Enzalutamide

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied. Enzalutamide is primarily metabolized by CYP2C8 and induces UGTs. Coadministration may decrease abacavir concentrations due to induction of UGTs although to a limited extent. No a priori dose adjustment is required.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Remdesivir

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Abacavir is metabolized by alcohol dehydrogenase and UGTs. Remdesivir does not interfere with abacavir’s metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Fezolinetant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Fezolinetant is primarily metabolised by CYP1A2 and to a lesser extent by CYP2C9 and CYP2C19. Abacavir is metabolised by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolising enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Tocilizumab

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. No effect on tocilizumab is expected as it is an IL-6 receptor monoclonal antibody and likely undergoes elimination via binding to its target antigen. Abacavir is metabolised by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolizing enzymes.

Description:

(See Summary)

No Interaction Expected

Abacavir (ABC)

Ospemifene

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ospemifene is primarily metabolised by CYP3A4 and CYP2C9; CYP2C19 and UGTs 1A3, 2B7, 1A1 and 1A8 also contribute to its metabolism. Abacavir is metabolised by alcohol dehydrogenase and UGTs and has no inhibitory or inducing effects on drug metabolising enzymes. Ospemifene and its major metabolite inhibit UGT1A3 and UGT1A9 but no interaction is expected as abacavir is metabolised by UGT2B7.

Description:

(See Summary)